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The threshold of viability
What is the real threshold of viability? Seaton et al report mortality in a large population over 20 years for babies of less than 26 weeks. They show how survival has improved for babies of 24 weeks and above, but in some respects the group of greatest interest was those babies of 23 weeks, since no baby of 22 weeks survived. The increase in survival rates at 23 weeks was not statistically significant, but Seaton et al show that in recent years these babies have tended to live longer and now consume significant resources. They also raise the issue as to whether present models of neonatal care are appropriate for babies of 23 weeks: would it make better sense to centralise their care into the largest facilities where expertise in the management of such immature babies can be concentrated, rather than the present model that distributes the babies around many units? See page F15
The probiotic debate
It is becoming more …
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