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Improving survival rates for extremely premature babies mean it is now possible to save the lives of babies born at 22 weeks, guidance says. Previously it was recommended that only babies born at 23 weeks or later were given treatment to save their lives. But there is now evidence those born earlier can survive - although only in small numbers - the British Association of Perinatal Medicine said. It said most will die but a third may survive where treatment is possible. Prof Dominic Wilkinson, a consultant neonatologist who helped draw up the guidance, said since the previous guidance was published, advances in treatment meant doctors were trying to save the lives of some babies born at 22 weeks. He said evidence from those cases had convinced BAPM to update its guidance. He said it was "fantastic news" that some babies born at such an early stage were now surviving. But he added: "The very high risks mean it's not always the right thing to do to provide intensive medical treatment." Survival for babies born before 22 weeks is not considered possible because the lungs are not developed enough. The twins who survived at 22 weeks Ruben and Jenson Powell became the youngest surviving pre-term twin boys born in Britain when they were born in August last year at 22 weeks and six days. Parents Jennie and Rich, from Brighton, were in Cornwall when Mrs Powell went into labour. They were flown to a specialist hospital in Oxford where the twins were born the next day. "It really is a story of hope and miracles," said Mrs Powell. "They defied every set of odds that they were given." Eight days after delivery, Ruben had a lifesaving operation when his intestines failed but battled through despite the low survival rate. Jenson also suffered from weakness in his lungs but pulled through. The twins had to have 20 blood transfusions, eye injections and laser surgery to prevent blindness and survived both blood poisoning and pneumonia. What are the chances of survival at 22 weeks? Despite progress, the chances of survival are still low. Most babies born at 22 weeks will die. Data from 2016 showed there were 486 births at this stage - and in more than 300 cases, the babies did not survive labour. Of those that did, 140 were not in a condition where attempting to save them was deemed possible and they would have been given palliative care to ease their suffering. But where treatment other than palliative care was given, just over a third of the babies survived. The guidance said decisions about whether to offer potential lifesaving treatment depended on the individual baby's circumstances. Decisions should be reached by specialists in consultation with parents. But it said intensive treatment would simply not be appropriate for many. What about babies born above 22 weeks? Once you get to over 22 weeks, the chances of survival increase week-by-week. Similar numbers are born at 23 weeks and in around half of cases lifesaving treatment is attempted. In 2016, 38% survived - double the rate 10 years previously. Once a baby gets to 26 weeks, treatment is proceeded on in most cases and 82% survive. But despite the increase in survival, significant numbers of these babies will have severe disabilities. At 22 weeks, a third of those that survive do. At 26 weeks it is one in 10. Prof Andrew Whitelaw, an expert in neonatal medicine at Bristol University, said the guidance was "very useful". He said it was important not to get too fixed on the number of weeks and instead the condition of the baby at birth and different attitudes on what is considered "unacceptable disability" were important factors. Why are chances of survival increasing? There are a variety of reasons. Over the years, doctors and the wider health teams have got incrementally better at treating mothers and babies. Steroids are given before birth to help boost the function of the lungs. Techniques for ventilating and preventing infection among extremely premature babies have also improved. The numbers of extremely premature babies being born in specialist hospitals have increased too. A decade ago just over half were. Now it is close to 80%.

Acting US Ambassador to Ukraine Bill Taylor spoke to Congress behind closed doors for more than nine hours on Tuesday, providing testimony alternatively described as explosive or inconclusive, depending who was doing the talking. Although Taylor didn't appear in front of television cameras, his 15-page opening statement was quickly leaked to the Washington Post, providing the veteran diplomat's unfiltered take on his connection to the rapidly unfolding story of the Trump administration's Ukraine policy machinations. The picture Taylor paints isn't a positive one for the White House, bolstering Democratic claims that his testimony was more bombshell than dud. Here are five takeaways from Taylor's opening statement, which reportedly took more than an hour to deliver and elicited sighs and gasps from those in attendance. 1. Trump the 'businessman' At this point there's little question that Donald Trump, whose background is in real estate and reality television, has made for an unconventional president. Supporters have touted this as a strength - something US Ambassador to the EU Gordon Sondland leaned into during an 8 September phone conversation detailed by Taylor. Sondland - who was part of what Taylor described as an "irregular, informal channel of US policy-making" that included Energy Secretary Rick Perry and Trump lawyer Rudy Giuliani - was explaining how Trump wanted Ukrainian President Volodymyr Zelensky to make a public statement about opening investigations that could potentially be damaging to Democrats. According to Taylor, Sondland said Trump was a businessman, and "when a businessman is about to sign a cheque to someone who owes him something… the businessman asks that person to pay up before signing the cheque". Taylor balked at this, insisting that Ukraine didn't "owe" the US anything. Much of the controversy around Trump's back-channel US-Ukraine policy has centred around whether there was a "quid pro quo" - a promise of Ukrainian action that could be politically beneficial to the president in exchange for releasing US military assistance and giving Zelensky a coveted White House visit. It doesn't take a working knowledge of Latin to figure that the "businessman deal" Taylor describes is exactly such an arrangement. 2. The mystery budget woman There have been multiple reports that the order to suspend US military aid to Ukraine came directly from the president. Taylor's statement corroborates this, in a somewhat unusual fashion. He describes an 18 July National Security Council video-conference in which the topic of the delayed military aid came up. A woman who said she was from the White House budget office (OMB) - Taylor could not tell who because she was off-screen - said that "her boss" had instructed her not to approve any additional security money to Ukraine "until further notice". That boss would be Mick Mulvaney, head of the budget office and the president's acting chief-of-staff. The unidentified woman went on to say that "the directive had come from the president to the chief-of-staff to the OMB". "In an instant," Taylor testified, "I realised that one of the key pillars of our strong support for Ukraine was threatened." Democrats are probably already scouring the OMB staff list to determine the identity of the mystery woman - although they may have little luck getting her to testify. Other officials in the agency have already refused Democratic subpoenas to appear before the impeachment inquiry. 3. Ukraine under siege Taylor detailed the strategic significance of Ukraine, underlining that he viewed Trump's decision to delay military aid as one that put lives at risk. In one of the most dramatic passages of Taylor's opening statement, he describes a visit to the eastern front of Ukraine's civil war, where he stared across a river at Russian-led military forces. He relayed his unease as the Ukrainian military commander thanked him for military support Taylor knew was being delayed. "Over 13,000 Ukrainians had been killed in the war, one or two a week," Taylor testified. "More Ukrainians would undoubtedly die without the US assistance." Taylor bookended his opening statement by emphasising the importance of US support for Ukraine and the heroism of the Ukrainian people, who he said were standing up to Russian aggression and yearning for a "more secure and prosperous life". "If we believe in the principle of sovereignty of nations on which our security and the security of our friends and allies depends, we must support Ukraine in its fight against its bullying neighbour," he said. In Taylor's opinion, the stakes were too high for what he saw as the administration's back-channel efforts to use Ukraine as a pawn in an US political game; it was more than a political controversy, for Ukrainians it was a matter of life or death. 4. Tim Morrison, check your messages A key figure emerging from Taylor's opening statement has yet to appear before Congress - Tim Morrison, Eurasia expert on the National Security Council staff. Some of the most damaging details about White House efforts to pressure Ukraine were relayed to Taylor from Morrison. For instance, on 1 September, Taylor says Morrison attended a meeting in Warsaw between Sondland and a Ukrainian official, Andrey Yermak, in which the EU ambassador directly tied security assistance to opening an investigation into the Ukrainian energy company with ties to the Bidens. Morrison also attended a meeting in Warsaw between Zelensky and Vice-President Mike Pence, and reportedly listened in on the fateful 25 July phone call between Trump and Zelensky during which the US president asked for investigatory "favours" from his counterpart. House impeachment investigators have already requested that Morrison appear before Congress. That request will take on additional urgency - and may turn into an official subpoena - with Taylor's testimony in the books. 5. An independent voice In a statement released by the White House after Taylor's congressional appearance, press secretary Stephanie Grisham suggested the 72-year-old ambassador was part of a far-left "smear campaign" by Democrats and a group of "radical unelected bureaucrats waging war on the Constitution". Such an assertion is difficult to square with Taylor's long record of public service, however. A West Point military academy graduate and Bronze Star-awarded Vietnam War veteran, Taylor worked as a low-level congressional staffer for New Jersey Democratic Senator Bill Bradely before becoming a diplomat in the Bill Clinton, George W Bush and Barack Obama administrations. He served as US ambassador to Ukraine from June 2006 to May 2009 and was convinced to return to the job earlier this year by Trump's own secretary of state, Mike Pompeo. Taylor's opening statement was methodical and meticulous, corroborating previous revelations and fleshing out key details. He reportedly has taken extensive notes that could supplement his testimony, as well, if Democrats can get the State Department to hand them over. It is in the White House's interests to undermine Taylor's authority and credibility, particularly if he publicly testifies at some point, but doing so will be no easy task.