Behandlingsvalg ved meget for tidlig fødsel. En landsdaekkende spørgeskemaundersøgelse

The principles for treatment of very premature deliveries in obstetric, surgical and paediatric departments were investigated by means of a questionnaire. This contained fictitious case histories about transfer in cases of threatened delivery, caesarean section in cases of interuterine asphyxia, resuscitation after delivery, transfer to a paediatric department and employment of respirators in cases of increasing respiratory difficulty following deliveries after 24, 26 and 28 full weeks of pregnancy. Replies were obtained from 26 out of 29 maternity departments, 28 out of 33 surgical departments with more than 100 deliveries in 1985, and 18 out of 18 paediatric departments. In all of the situations, considerable restraint was expressed as regard the most premature deliveries. For example, only two obstetric departments, two surgical and four paediatric departments stated that they would, as a rule, attempt resuscitation after deliveries at gestational ages of 24 weeks. For deliveries at 26 weeks, the figures were 18, 12 and 12, respectively. A certain tendency was observed for less restraint in 1985 as compared with 1979. Tendencies to centralize the very premature deliveries were greater in East Denmark than in West Denmark where respirator treatment was more frequently employed for the smallest infants.