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Review of the new BAPM framework for practice (2019): Perinatal management of extreme preterm birth before 27 weeks of gestation
  1. Nicola Crowley1,
  2. Grenville F Fox2
  1. 1 Neonatal Unit, Evelina London Children's Hospital, London, UK
  2. 2 Evelina London Children's Hospital Neonatal Unit, St Thomas' Hospital, London, UK
  1. Correspondence to Dr Nicola Crowley, Neonatal Unit, Evelina London Children's Hospital, London SE1 7EH, UK; nicola.crowley{at}

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Advances in perinatal care have resulted in increased survival for extremely preterm babies. Recent data suggest that outcomes for babies actively managed at 22 weeks of gestation in the UK may now be similar to babies born at 23 weeks of gestation.1

Previous guideline

The previous British Association of Perinatal Medicine (BAPM) guideline, ‘Framework for Clinical Practice for the Management of Babies born Extremely Premature at less than 26 weeks of gestation,’ was published in 2008.2 It was written in response to the 2006 report from the Nuffield Council on Bioethics, ‘Critical care decisions in fetal and neonatal medicine: ethical issues’.3

Both documents were produced using data from the EPICure study in 1995 and some preliminary data from EPICure 2.

They both used gestation alone to determine guidelines for the management of extremely preterm babies at birth.

Information about the new framework

‘Perinatal Management of Extreme Preterm Birth before 27 weeks of gestation – A Framework for Practice’ was published in October 2019 by BAPM.4

It is essential reading for all paediatricians, neonatologists, obstetricians and other health professionals involved in the care of mothers and babies around the time of extreme preterm birth.

The updated framework is designed to help with perinatal decision-making around extremely premature birth from 22+0 to 26+6 weeks of gestation. …

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  • Contributors The manuscript was written by NC and edited by GFF.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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