5. 6. 7. 8. 9. 10. 11. 12. 13. 14 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Page 4 of 4 *Required for saving **Conditionally required according to the events indicated in Plan Gestational Age Categories (continued) Extremely preterm Very preterm Moderate to late preterm Term Date: (<28 weeks) (28 to <32 weeks) (32 to <37 weeks) weeks) (≥37 PT VNT EMV PT VNT EMV PT VNT EMV PT VNT EMV 26. 27. 28. 29.
5. 6. 7. 8. 9. 10. 11. 12. 13. 14 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. Page 4 of 4 *Required for saving **Conditionally required according to the events indicated in Plan Gestational Age Categories (continued) Date: Extremely preterm (<28 weeks) Very preterm (28 to <32 weeks) Moderate to late preterm (32 to <37 weeks) Term (≥37 weeks) PT VNT EMV PT VNT EMV PT VNT EMV PT VNT EMV 26. 27. 28. 29.