Development timeline: March to December 2019
New guidance is coming for Victorian healthcare services to help manage extreme prematurity, including:
- consensus statement on the zone of parental discretion
- guidance on managing pregnant women at high risk of giving birth between 22+0 to 24+6 weeks’ gestation
- guidance on managing an infant born at 22+0 to 24+6 weeks’ gestation, including active management and palliative care
- plain language resources and information for parents and families.
To develop this guidance we will:
- seek feedback on the draft guidance from stakeholders and the sector in November 2019 and
- get it independently reviewed.
Why are we developing this guidance?
Recommendations from the 2018 Parliamentary Inquiry into Perinatal Services include developing evidence-based policies and protocols in obstetric and neonatal care, for health services across Victoria..
The Neonatal Advisory Group (NAG) identified:
- inconsistent management of births at 22+0 to 24+6 weeks’ gestation
- unequal access to tertiary obstetric and neonatal care, and
- inconsistent access to high-risk counselling for families by experienced clinicians
These differences contributed to variation in outcomes for babies born at 22+0 to 24+6 weeks’ gestation and highlighted a need for statewide guidance.
The extreme prematurity guidance will provide evidence-based guidance for clinicians throughout Victoria who care for high-risk pregnant women and newborn babies to reduce variation in care, including access to tertiary perinatal care and guidance for immediate management of the baby at birth.
Scope of guidance
This guidance is being developed for all staff working in perinatal services in Victoria, including medical, nursing, midwifery and allied health care professional staff in regional and metropolitan, tertiary and non-tertiary health services.
The guidance is also for clinicians working in the statewide perinatal and retrieval services at the Paediatric Infant Perinatal Emergency Retrieval (PIPER).
Paramedics and clinicians working in Ambulance Victoria (AV) may refer to this guideline, however AV Clinical Practice Guidelines should remain the default for care of the woman and baby in the pre-hospital environment.
Expert working group membership
Dr Stefan Kane
|Royal Women’s Hospital|
|Associate Professor Jeanie Cheong||
Tertiary Neonatologist & Convenor, Victorian Infant Collaborative Study (VICS) & CRE in Newborn Medicine
|Royal Women’s Hospital
Murdoch Children’s Research Institute
|Jane Bailey||Clinical Nurse Consultant, NICU||Royal Women’s Hospital|
|Dr Rosemarie Boland||Senior Project Officer||
Safer Care Victoria
|Dr Jim Holberton||Tertiary Neonatologist||Mercy Hospital for Women|
|Kathleen Jones||Regional Midwife||University Hospital Geelong|
|Dr Isaac Marshall||Regional Paediatrician||University Hospital Geelong|
|Dr Antoinette Mowbray||Regional GP Obstetrician||Bairnsdale|
|Dr Trisha Prentice||Tertiary Neonatologist & Bioethics specialist||Royal Children’s Hospital|
|Dr Calum Roberts||Tertiary Neonatologist||Monash Children’s Hospital|
|Associate Professor Michael Stewart||Director, Paediatric Infant Perinatal Emergency Retrieval (PIPER)||Royal Children’s Hospital|
|Dr Kae Sheen Wong||Regional Specialist Obstetrician||Wodonga|
Working group terms of reference
Last updated 28 Oct 2019
Page last updated: 11 Nov 2020