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.