Overlevingskans van zeer immature pasgeborenen in Nederland
article
National perinatal databases were used to investigate perinatal care at the limits of viability. In 1995 data on 756 of al approximately 800 children with a gestational age between 22 and 27 weeks were available. The intensiveness of obstetrical care increased with increasing maturity. Caesarean sections increased from 2% at 24 and 25 weeks to 18% at 26 weeks and the percentage of infants born in a tertiary centre increased from 21% at 22 weeks to 71% at 26 weeks gestation. More than half of the infants were stillborn, chance of survival in liveborn infants increased from less than 1% at 22 and 23 weeks to 54% at 26 weeks gestation. Neonatal data on periventricular leucomalacia were incomplete, mostly small intracranial haemorrhages were reported in 23% of survivors. All survivors needed prolonged mechanical ventilation (means 38 days) and 61% of survivors had brochopulmonary dysplasia. Follow-up data on these children are not available on a national base, but the risk for developmental problems in these immature infants is considerable. Children that died after admittance still had a prolonged stay up to 162 days (mean 15 days) in a tertiary neonatal intensive care unit. Considering the small chance of survival, the uncertainty of the long term outcome and the long hospital stay in children that eventually still died a conservative approach to infants at the limit of viability is probably still the best choice for most parents.
TNO Identifier
235848
ISSN
03767442
Source
Tijdschrift voor Kindergeneeskunde, 68(6), pp. 241-246.
Pages
241-246
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