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Where should extreme preterm babies be delivered? Crucial data from EPICure
  1. Ian A Laing
  1. Correspondence to Dr Ian A Laing, Neonatal Unit, Simpson Centre for Reproductive Health, 51 Little France Crescent, Edinburgh EH16 4SA, UK; ian.laing{at}luht.scot.nhs.uk

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In the UK all maternity services require to be able to provide expert resuscitation for emergency or unpredicted deliveries, including those of extreme preterm babies. After initial stabilisation there is then a choice between retaining the infant in the local neonatal unit or transferring to a larger perinatal centre. Where an extreme preterm baby is to be delivered electively, parents may require, with guidance, to decide whether to deliver close to home or to elect to travel further afield to a larger perinatal centre. It is the responsibility of involved professionals to help such parents make informed choices for their baby and family. Such guidance needs to be supported by the highest quality information.

In the last 10 years Managed Clinical Networks (MCNs) have been developed. These have given professionals an excellent opportunity to share information, to learn from each other's practice and to organise services in larger regions, thus enabling professionals to play to the strengths of the Units within their Regions. It is not necessary for all Neonatal Intensive Care Units (NICUs) to provide the expertise and services needed to manage the baby on extracorporeal membrane oxygenation, nor the baby who needs therapeutic cooling, nor the baby of 23 weeks’ gestation. Neither is it …

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