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Am J Obstet Gynecol. 1998 May;178(5):909-15.

The impact of fetal compromise on outcome at the border of viability.

Author information

1
Department of Pediatrics, William Beaumont Hospital, Royal Oak, Michigan 48073-6769, USA.

Abstract

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.

PMID:
9609558
[Indexed for MEDLINE]

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