Periviable counselling — RACP Paediatrics MCQ

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ModerateNeonatalPeriviable counsellingRACP Paediatrics

A mother presents in preterm labour at 23+0 weeks gestation. Antenatal steroids have been given. The parents wish to discuss the prognosis and options for their baby. Per Australian guidelines, what is the most important initial step?

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Correct answer: A — Antenatal counselling with neonatologist

Antenatal counselling by a senior neonatologist is essential at periviable gestations (22-25 weeks in Australia). The discussion should include survival statistics (which vary by centre), risks of severe disability, and the options available (active resuscitation vs comfort care). Per RACP/PIC guidelines, shared decision-making between the family and clinical team is paramount. Both active treatment and comfort care are reasonable options at 23 weeks.

Reference: RACP – 2021 – Decision-Making at End of Life in Infants, Children and Adolescents; ANZCOR – 2025 – Guideline 13.10