Change in the Limit of Viability of Fetal Infants.
- Author:
Chang Won CHOI
1
;
Jong Hee HWANG
;
Jae Won SHIM
;
Sung Sin KIM
;
Sun Young KO
;
Eun Kyung LEE
;
Yun Sil CHANG
;
Won Soon PARK
Author Information
1. Department of Pediatrics, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea. wspark@smc.samsung.co.kr
- Publication Type:Original Article
- Keywords:
Viability;
Survival rate;
Fetal infants;
Limit
- MeSH:
Birth Weight;
Body Weight;
Gestational Age;
Hemorrhage;
Humans;
Incidence;
Infant*;
Infant, Newborn;
Intensive Care, Neonatal;
Leukomalacia, Periventricular;
Lung Diseases;
Medical Records;
Parturition;
Retinopathy of Prematurity;
Survival Rate
- From:Journal of the Korean Pediatric Society
2003;46(12):1194-1199
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To determine the change in the limit of viability in fetal infants and the incidence of major complications in neonatal intensive care unit(NICU) at Samsung Medical Center(SMC). METHODS: Sevety-three infants weighing less than 800 g at birth and 117 infants born earlier than 27 weeks gestational age, who were admitted to NICU at SMC between November 1994 and December 2002, were enrolled. Their medical records were reviewed with a focus on the survival and major complications, including chronic lung disease, retinopathy of prematurity, intraventricular hemorrhage, and periventricular leukomalacia. The limit of viability in fetal infants was defined as the birth weight or gestational age at which a 50% survival rate is reached and the incidence of major complications were compared by period(period I : Nov. 1994-Dec. 1998, period II : Jan. 1999-Dec. 2002). RESULTS: The limit of viability in fetal infants was markedly lowered from birth weight range of 800-900 g or gestational age range of 26+0-26+6 weeks in period I to birth weight range of 600-700 g or gestational age range of 24+0-24+6 weeks in period II. The incidence rates of major complications at the limit of viability were all less than 50% in period II. There was no definite trend toward increased incidence of major complications as birth weight get smaller and gestational age get younger. CONCLUSIONS: Our results indicate that at present, fetal infants whose body weight is over 600 g, or whose gestational age is over 24 weeks should be resuscitated vigorously. The risk of major complications at this birth weight or gestational age seems to be not greater than that at a bigger birth weight or an older gestational age.
