Authors (in alphabetical order): Adams M, Berger TM, Diebold C, Dinten B, Fauchère JC, Gubler D, Hendriks M, Hodel M, Kind C, Martinez de Tejada B, Natalucci G, Pfister RE, Schulzke S, Surbek D, Truttmann AC.
Consultation: Swiss Society of Neonatology (SSN) (contact: Meyer, P), Swiss Society of Gynaecology and Obstetrics (SSGO) represented by the Swiss Academy for Foetomaternal Medicine (AFMM) (contact: Hodel, M), Swiss Society of Paediatrics (SSP) (contact: Bachmann, I), Swiss Society for Developmental Paediatrics (SSDP) (contact: Natalucci, G), Paediatric Palliative Care Network Switzerland (PPCN CH) (contact: Gubler, D), Swiss Federation of Midwives (contacts: Steiner A, Diebold C), Parent representatives from Né Trop Tôt (contact: Nguyen, L) and Frühchen Schweiz (contact: Hediger, D).
What is new?
The revised Swiss recommendations attempt to describe a medically and ethically sound approach to women and infants confronted with the risk of birth at an extremely low gestational age (< 28 0/7 weeks of gestation). They differ from the previous guidelines in several key aspects:
- They emphasize the limited value of risk assessment based on gestational age alone.
- The concept of a gestational age-based grey zone has been replaced by a structured and individualized risk assessment, which considers updated national and international information on mortality and morbidity rates of extremely low gestational age neonates (ELGANs).
- They explain the central role of SDM and, of particular importance, the active involvement of the parents in this process with appropriate consideration of their decisional authority and the women’s autonomy regarding obstetric interventions.
- They define the relevant elements of both survival- and comfort-focused perinatal care.
- They emphasise that the care of women at high risk of preterm delivery and preterm infants with an extremely low gestational age must be provided by an experienced interdisciplinary and interprofessional perinatal team who can support parents with compassionate guidance.
