OBJECTIVE: Our goal was to evaluate the impact of fetal compromise on the outcome of borderline viable babies. STUDY DESIGN: All 142 babies born in our hospital from 1990 to 1995 with a gestational age of 23 to 25 weeks were included. Fetal compromise was considered present if one of the following was documented: a major anomaly, congenital sepsis, chronic intrauterine infection, intrauterine drug exposure, congenital anemia, severe growth restriction, fetal acidosis, or cardiorespiratory and neurologic depression in the delivery room. RESULTS: The 43 babies who had at least one cause of fetal compromise had a lower birth weight (p < 0.001), but there were no other differences in demographics or complications of prematurity. The survival rate was significantly better for babies free of fetal compromise (75% vs 33%, p < 0.001), particularly for babies born at 23 weeks of gestation (75% vs 6%, p < 0.001). For surviving babies free of fetal compromise, the outcome at 23 weeks was comparable to that at 24 to 25 weeks for major causes of long-term neurologic morbidity. CONCLUSIONS: Like advancing gestational age and increasing birth weight, the absence of fetal compromise has a major beneficial impact on the outcome of borderline viable babies that might be important when decisions are made about the appropriate level of support.
OBJECTIVE: Our goal was to evaluate the impact of fetal compromise on the outcome of borderline viable babies. STUDY DESIGN: All 142 babies born in our hospital from 1990 to 1995 with a gestational age of 23 to 25 weeks were included. Fetal compromise was considered present if one of the following was documented: a major anomaly, congenital sepsis, chronic intrauterine infection, intrauterine drug exposure, congenital anemia, severe growth restriction, fetal acidosis, or cardiorespiratory and neurologic depression in the delivery room. RESULTS: The 43 babies who had at least one cause of fetal compromise had a lower birth weight (p < 0.001), but there were no other differences in demographics or complications of prematurity. The survival rate was significantly better for babies free of fetal compromise (75% vs 33%, p < 0.001), particularly for babies born at 23 weeks of gestation (75% vs 6%, p < 0.001). For surviving babies free of fetal compromise, the outcome at 23 weeks was comparable to that at 24 to 25 weeks for major causes of long-term neurologic morbidity. CONCLUSIONS: Like advancing gestational age and increasing birth weight, the absence of fetal compromise has a major beneficial impact on the outcome of borderline viable babies that might be important when decisions are made about the appropriate level of support.
Authors: Wessel Ganzevoort; Zarko Alfirevic; Peter von Dadelszen; Louise Kenny; Aris Papageorghiou; Aleid van Wassenaer-Leemhuis; Christian Gluud; Ben Willem Mol; Philip N Baker Journal: Syst Rev Date: 2014-03-11
Authors: A Pels; L C Kenny; Z Alfirevic; P N Baker; Peter von Dadelszen; C Gluud; C T Kariya; B W Mol; A T Papageorghiou; A G van Wassenaer-Leemhuis; W Ganzevoort; K M Groom Journal: BMC Pregnancy Childbirth Date: 2017-12-28 Impact factor: 3.007
Authors: David A Paul; Kathleen H Leef; Robert G Locke; Louis Bartoshesky; Judy Walrath; John L Stefano Journal: BMC Pediatr Date: 2006-02-06 Impact factor: 2.125