The variability of viability: The effect of physicians' perceptions of viability on the survival of very low-birth weight infants

Attitudes of Level II obstetricians towards the care of the extremely premature infant: A national survey

“…There is, however, a significant underestimation of infant survival, especially at the extremes of prematurity (22−25 weeks’ gestation) and birthweights (< 500 g) when compared to available Australian data 9 . This tendency towards underestimation has been previously observed among Australian neonatologists 8,12 and Australian and American obstetricians 1,2,13,14 . The underestimation may be a result of the fact that NICU data collections only represent those infants admitted.…”

Attitudes of neonatal clinicians towards resuscitation of the extremely premature infant: An exploratory survey

“…Nevertheless, neither neonatologists nor nurses would get the opportunity to resuscitate an infant if the obstetric team had not requested resuscitation. Forty‐four per cent of obstetricians surveyed by Goldenberg et al 1 in 1982 would not actively monitor a pregnancy of 24 weeks gestation because they believed it was potentially non‐viable. A recent survey in 1994 found physicians delivering obstetric care significantly underestimate rates of survival and freedom from handicap from 23 through 34 weeks gestation preterm infants.…”

“…Medical opinion as to which preterm infant is ‘viable’ and hence ‘deserving’ of intensive care will inevitably determine the course of that infant’s life. 1 Nevertheless, the ultimate decision to resuscitate and offer intensive care may merely be ‘self‐fulfilling prophecies’. 2 Previous reports have suggested that higher rates of survival and intact survival of infants < 800 g may be related to difference in attitudes in neonatal care.…”

Characterising doctor-parent communication in counselling for impending preterm delivery

“…Previous investigations suggest that extraneous factors may compromise the parents' ability to rationally assess competing risks versus benefits. These factors include inconsistency of neonatal outcome data provided to parents by clinicians, [4][5][6][7][8][9][10][11] potentially impaired ability to retain and to understand this information in stressful periods such as labour, 12 time constraint, anxiety, [13][14][15] and even the willingness or confidence of parents to be involved in decision making. 16 To understand further the cumulative effects and interactions between these factors, we carried out a questionnaire based descriptive study of parents facing imminent preterm delivery.…”