The impact of fetal compromise on outcome at the border of viability☆,☆☆,★
Section snippets
Methods
All babies born at our hospital from Jan. 1, 1990, through Dec. 31, 1995, who were 23 to 25 completed weeks of gestation by obstetric estimate were included in this review. Ninety-eight percent of these mothers received prenatal care. The obstetric estimate of gestational age was based on postmenstrual dates and supported by prenatal ultrasonography in 92% of the cases. Physical examination of the baby was used to establish gestational age only if no prenatal data were available.
A list of
Results
During the study period 142 babies from 23 to 25 completed weeks of gestation were born alive at our hospital, and all babies were included in the study. By our criteria 99 were free of fetal compromise, whereas 43 had at least one additional fetal problem (Table I).
Diagnosis No. of babies Severe cardiorespiratory and neurologic depression upon delivery 20 Congenital anemia 16 Severe intrauterine growth restriction 7 Cord acidosis 6 Congenital sepsis 2 Major
Comment
We realize that unique features of our population (98% of mothers received prenatal care and 99% of infants were intubated in the delivery room) may make it difficult to generlize our results to other populations. Neveretheless, our data support the idea that for our population, in addition to gestational age and birth weight, the prenatal condition of the baby is an important determinant of outcome for borderline viable babies. In this retrospective study we attempted to identify those babies
Acknowledgements
We acknowledge the thoughtful review of Dr. M. Jeffrey Maisels.
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Cited by (0)
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From the Division of Newborn Medicine, Department of Pediatrics, William Beaumont Hospital.
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Reprint requests: Daniel G. Batton, MD, William Beaumont Hospital–Royal Oak, 3601 W. 13 Mile Road, Royal Oak, MI 48073-6769.
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