Limits of viability: Definition of the gray zone

Journal of Perinatology

Volumn 28, Issue , 2008, Pages S4-S8

  Seri, I ^a   Evans, J ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

Evidence and nonevidence based algorithm; Grayzone; Infant viability; Neurodevelopmental outcome; Qualitative benefit

Indexed keywords

ALGORITHM; ARTICLE; BIRTH WEIGHT; DECISION MAKING; DEVELOPMENTAL DISORDER; EVIDENCE BASED MEDICINE; EXTREMELY LOW BIRTH WEIGHT; FEMALE; FETAL WELL BEING; GESTATIONAL AGE; HUMAN; HUMAN RELATION; NEWBORN; NEWBORN INTENSIVE CARE; PHYSIOLOGY; PREGNANCY; PREMATURITY; PROFESSIONAL COMPETENCE; RESUSCITATION; TREATMENT OUTCOME; TREATMENT WITHDRAWAL; CONFERENCE PAPER; CONSULTATION; DELIVERY; MEDICAL DECISION MAKING; MENTAL DEVELOPMENT; NEWBORN ASSESSMENT; NEWBORN CARE; NEWBORN MORTALITY; PARENTAL ATTITUDE; PATIENT AUTONOMY; PRENATAL CARE; UNCERTAINTY;

ALGORITHMS; BIRTH WEIGHT; DECISION MAKING; DEVELOPMENTAL DISABILITIES; EVIDENCE-BASED MEDICINE; FEMALE; FETAL VIABILITY; GESTATIONAL AGE; HUMANS; INFANT, EXTREMELY LOW BIRTH WEIGHT; INFANT, NEWBORN; INFANT, PREMATURE, DISEASES; INTENSIVE CARE, NEONATAL; MEDICAL FUTILITY; PREGNANCY; PROFESSIONAL COMPETENCE; PROFESSIONAL-FAMILY RELATIONS; RESUSCITATION; WITHHOLDING TREATMENT;

EID: 43049130005     PISSN: 07438346     EISSN: 14765543     Source Type: Journal    
DOI: 10.1038/jp.2008.42     Document Type: Article

References (22)

1. The Victorian Infant Collaborative Study Group. Outcome at 2 years of children 23–27 weeks’ gestation born in Victoria in 1991–1992. J Paediatr Child Health 1997; 33: 161–165.
2. Batton DG, De Witte DB, Espinosa R, Swails TL. The impact of fetal compromise on outcome at the border of viability. Am J Obstet Gynecol 1998; 178: 909–915.
3. Draper ES, Manktelow B, Field DJ, James D. Prediction of survival for preterm births by weight and gestational age: retrospective population based study. BMJ 1999; 319: 1093–1097.
4. Lorenz JM. Survival of the extremely preterm infant in North America in the 1990s. Clin Perinatol 2000; 27: 255–262.
5. El-Metwally D, Vohr B, Tucker R. Survival and neonatal morbidity at the limits of viability in the mid 1990s: 22–25 weeks. J Pediatr 2000; 137: 616–622.
6. Wood NS, Marlow N, Costeloe K, Gibson AT, Wilkinson AR. Neurologic and developmental disability after extremely preterm birth. EPICure Study Group. N Engl J Med 2000; 343: 378–384.
7. Lorenz JM. The outcome of extreme prematurity. Semin Perinatol 2001; 25: 25348–25359.
8. Doyle LW, the Victorian Infant Collaborative Study Group. Neonatal intensive care at borderline viabilityFis it worth it? E Hum Develop 2004; 80: 103–113.
9. Kaiser JR, Tilford JM, Simpson PM, Salhab WA, Rosenfeld CR. Hospital survival of very-low-birth-weight neonates from 1977 to 2000. J Perinatol 2004; 24: 343–350.
10. Marlow N, Wolke D, Bracewell MA, Samara M, the EPICure Study Group. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med 2005; 352: 71–72.
11. Chervenak FA, McCullough LB, Levene MI. An ethically justified, clinically comprehensive approach to peri-viability: gynecological, obstetric, perinatal and neonatal dimensions. J Obstet Gynaecol 2007; 27: 3–7.
12. Singh J, Fanaroff J, Andrews B, Caldarelli L, Lagatta J, Plesha-Troyke S et al. Resuscitation in the gray zone of viability: determining physician preferences and predicting infant outcomes. Pediatrics 2007; 120: 519–526.
13. Lantos JD, Meadow WL. Neonatal Bioethics: The Moral Challenges of Medical Innovation. Johns Hopkins University Press: Baltimore, MD, 2006.
14. Vohr BR, Wright LL, Dusick AM, Mele L, Verter J, Steichen JJ et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Research Network 1993–1994. Pediatrics 2000; 105: 1216–1226.
15. Hack M, Fanaroff AA. Outcomes of children of extremely low-birth weight premature infants in the 1990s. Early Hum Dev 1999; 53: 195–218.
16. Mestan KK, Marks JD, Hecox K, Huo D, Schreiber MD. Neurodevelopmental outcomes of premature infants treated with inhaled nitric oxide. N Engl J Med 2005; 353: 23–32.
17. Schreiber MD, Gin-Mestan K, Marks JD, Huo D, Lee G, Srisuparp P. Inhaled nitric oxide in premature infants with the respiratory distress syndrome. N Engl J Med 2003; 349: 2099–2107.
18. Allen MC, Donohue PK, Dusman AE. The limit of viabilityFneonatal outcome of infants born at 22–25 weeks’ gestation. N Engl J Med 1993; 329: 1597–1601.
19. Markestad T, Kaaresen PI, R_nnestad A, Reigstad H, Lossius K, Medb_ S et al. Early death, morbidity and need of treatment among extremely premature infants. Pediatrics 2005; 115: 1289–1298.
20. Walther FJ. Withholding treatment, withdrawing treatment, and palliative care in the neonatal intensive care unit. Early Hum Dev 2005; 81: 965–972.
21. Lucey JF, Rowan CA, Shiono P, Wilkinson AR, Kilpatrick S, Payne NR et al. Fetal infants: the fate of 4172 infants with birth weights of 401–500 gramsFthe Vermont Oxford Network experience (1996–2000). Pediatrics 2004; 113: 1559–1566.
22. Serenella-Pignotti M, Donzelli G. Perinatal care at the threshold of viability: an international comparison of practical guidelines for the treatment of extremely preterm births. Pediatrics 2008; 121: e193–e198.