Treatment Plan Part A―British Colombia Level of Care Needed Based on GA Needs of Newborn | |
GA (weeks) | Treatment Plan |
<26 $ | Transfer to Lever 3b High Acuity NICU $ |
26 - 29+6 $ | Transfer to Lever 3a High Acuity NICU $ |
30 - 34+6 $ | Transfer to Level 2a (32 - 34+6) or 2b (30 - 31+6) NICU $ |
35 - 35+6
$ | Level 1b Well Newborn Nursery at local rural centre so long as criteria under Treatment Plan Part B are met and no exclusion criteria under Treatment Plan Part C are met. $ |
≥37 | Level 1a Well Newborn Nursery at local rural centre so long as criteria under Treatment Plan Part B are met and no exclusion criteria under Treatment Plan Part C are met. |
Treatment Plan Part B―Delivery Criteria for 36 - 40 Weeks GA Level 1 Nursery Vaginal Delivery | |
1) Vertex presentation 2) Caesarean section back up available on site 3) Unconcerning Foetal Growth Scan at 32 - 34 weeks GA for delivery planning 4) Unconcerning Cervical length monitoring via transvaginal ultrasound (could consider less accurate manual examination) to monitor preterm delivery risk if deemed necessary (length ≥ 25 - 30 mm is reassuring): 18 - 20 and 28 - 34 weeks GA | |
Treatment Plan Part C―Exclusion Criteria for 36 - 40 Weeks GA Level 1 Nursery Delivery | |
1) Breech presentation 2) Thick and inelastic vaginal septum 3) Intrauterine growth restriction 4) Polyhydramnios 5) Cervical incompetence if progressive |