Fetal monitoring
Fetal monitoring and obstetrical interventions during the periviable
period(21) would depend on institutional policies (e.g., NICU
capabilities), fetal factors (e.g., estimated weight), and patient’s
wishes (or families’ desires if periviability counseling has not been
performed before intubation). We recommend continuous fetal monitoring
past 26 weeks of gestation, which is typically easily achieved during
proning (Video 1). A correctly placed tocodynamometer will reliably
register uterine contractions. At our institution, a dedicated labor and
delivery nurse is assigned to any critically ill patient that requires
continuous monitoring.