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Perinatal care at an extremely low gestational age (22–25 weeks). An Italian approach: the “Carta di Firenze”
  1. Maria Serenella Pignotti1,
  2. Gianfranco Scarselli2,
  3. Ignazio Barberi3,
  4. Mauro Barni4,
  5. Giulio Bevilacqua5,
  6. Francesco Branconi6,
  7. Giovanni Bucci7,
  8. Mario Campogrande8,
  9. Pietro Curiel9,
  10. Romolo Di Iorio10,
  11. Gian Carlo Di Renzo11,
  12. Mariarosaria Di Tommaso12,
  13. Massimo Moscarini13,
  14. Gian Aristide Norelli14,
  15. Aldo Pagni15,
  16. Antonio Panti16,
  17. Ivana Pela17,
  18. Giorgio Rondini18,
  19. Giuseppe Saggese19,
  20. Giampaolo Salvioli20,
  21. Enrico Scarano21,
  22. Gianpaolo Donzelli22
  1. 1
    Neonatal Medicine, University of Florence, Florence, Italy
  2. 2
    Department of Obstetrics and Gynaecology, University of Florence, Florence, Italy
  3. 3
    Department of Paediatrics and Neonatology, University of Messina, Messina, Italy
  4. 4
    Bioethics Committee, Tuscany, Italy
  5. 5
    Department of Gynaecology, Obstetrics and Neonatology, University of Parma, Parma, Italy
  6. 6
    Department of Obstetrics and Gynaecology, University of Florence, Florence, Italy
  7. 7
    Emeritus of Paediatrics and Neonatology, Rome, Italy
  8. 8
    Department of Obstetrics and Gynaecology, Sant’Anna Hospital, Turin, Italy
  9. 9
    Past President, Associazione degli Ostetrici e Ginecologi Ospedalieri Italiani (AOGOI), Italy
  10. 10
    Department of Gynaecology, Perinatology and Child Health, La Sapienza University, Rome, Italy
  11. 11
    Department of Obstetrics and Gynaecology, University of Perugia, Italy
  12. 12
    Department of Obstetrics and Gynaecology, University of Florence, Florence, Italy
  13. 13
    Department of Gynaecology, Perinatology and Child Health, La Sapienza University, Rome, Italy
  14. 14
    Department of Legal Medicine, University of Florence, Florence, Italy
  15. 15
    President, Commissione Codice Deontologico of the FNOMCeO, Italy
  16. 16
    President, Ordine dei Medici of Florence, Florence, Italy
  17. 17
    Bioethics Committee, Tuscany, Italy
  18. 18
    Department of Paediatrics, University of Pavia, Pavia, Italy
  19. 19
    Department of Paediatrics, University of Pisa, Pisa, Italy
  20. 20
    Department of Paediatrics and Neonatology, University of Bologna, Bologna, Italy
  21. 21
    Neonatal Medicine, University of Florence, Florence, Italy
  22. 22
    Neonatal Medicine, University of Florence, Florence, Italy
  1. Dr Maria Serenella Pignotti, Neonatal Medicine, A Meyer Children Hospital, University of Florence, Italy, Via Luca Giordano 13- 50132 – Firenze; m.pignotti{at}meyer.it

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Guidelines on life or death strategies in extremely preterm infants have been formulated in various countries worldwide.115 The general agreement is not to initiate resuscitation in neonates when gestational age is less than or equal to 22 weeks, and intensive care is assured for infants of 25 weeks and over; in the middle there is a sort of “grey zone”. To provide helpful suggestions for initial management of threatened birth in infants at a gestational age of 25 completed weeks or less, a …

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