Each birth institution should have a consistent approach based upon the best available evidence regarding clinical care, including parental counseling with information regarding prognosis in cases where the fetal/neonatal outcome is a concern. In particular, antenatal counseling should be provided to parents in the setting of an anticipated delivery of an extremely low birth weight (ELBW) infant (BW <1000 g) as recommended by the American Academy of Pediatrics (AAP).
Such Counseling sessions with prospective parents should ideally be done with both-Obstetric and Neonatology teams together.
Following are the AAP guidelines:
· If there is no chance of survival, resuscitation should not be initiated.
· When a good outcome is considered very unlikely, the parents should be given the choice of whether resuscitation should be initiated, and clinicians should respect the preference opted by parents.
· If a good outcome is considered reasonably likely, clinicians should initiate resuscitation and, together with the parents, continually re-evaluate whether intensive care should be continued.
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