Erstversorgung von Frühgeborenen an der Grenze der Lebensfähigkeit

Abstract

Kinder-und Jugendheilkunde (ÖGKJ) 2 Arbeitsgruppe für Ethik in der Kinder-und Jugendheilkunde der Österreichischen Gesellschaft für Kinder-und Jugendheilkunde (ÖGKJ)

Low mortality and short‐term morbidity in very preterm infants in Austria 2011–2016

“…To compare our outcome data to those of other populations, the Austrian healthcare system and policy on treatment of very preterm infants must be taken into account. According to national guidelines, proactive care is offered to extremely preterm babies with a gestational age of 23 weeks or older . Prenatal care in Austria is well structured, free of charge and accessible for every pregnant woman.…”

A 10 year comparative study of caesarean deliveries using the Robson 10 group classification system in a university hospital in Austria

“…Despite its limitations, it showed a tendency toward better neonatal outcomes in small for gestational age infants (from 23+0 till 30+6 gestational weeks) as well as a benefit in appropriate for gestational week infants (from 23+0 till 27+6 gestational weeks) [10]. Furthermore in 2016 the guidelines for management of premature infants at the border of viability published by Austrian Society of Paediatrics and Adolescent Medicine clearly stated that in extreme preterm infants caesarean delivery is associated with better neonatal outcomes and a planned caesarean delivery should be the method of choice [11]. Although the Austrian Society for Gynaecology and Obstetrics (OEGGG) [12] did not agree with the before mentioned statement both articles illustrate a possible influence on the general mindset regarding preterm delivery mode in Austria.…”

Neonatology in Austria: ethics to improve practice

“…In the decision-making around the limit of viability in Austria, shared procedures have been long established in the morally ambiguous grey zone (now, the 23rd week of gestation (Berger 2017 )) where it is ultimately the parents who act as surrogate decision-makers on behalf of the EP infant. It is the so called zone of parental discretion (Gillam et al 2017 ).…”

“…The normatively tense cases that are at the backdrop of this essay concern the situations around the limit of viability (weeks 22 + 0 days to 25 + 6 days of gestation), which is the point in the development of an extremely preterm (EP) infant at which there are chances of extra-uterine survival (Ehrenkranz and Mercurio 2017 ). Currently, according to the Austrian guideline on the management of EP infants, comfort (palliative) care is recommended in 22nd week, shared decision-making with parents in the grey zone in 23rd week, and active care interventions from 24th week onwards (Berger 2017 ). This essay first outlines the key explicit ethical challenges present at the limit of viability.…”