[Peri-viability: limits of prematurity in a regional hospital in the last 10 years]

Abstract

Aim: To determine the preterm viability between 22 and 25 gestational weeks in our hospital in last 10 years.

Patients and methods: A descriptive retrospective study was conducted on preterms between 22-25 gestational weeks born between 1-1-2002 and 12-31-2011.

Results: There were 121 newborns, 45 (37%) stillbirths and 76 (63%) live births (16 died in delivery room, and 60 admitted to neonatal intensive unit). Among the 60 admitted, 34 died before hospital discharge, and 26 survived (21% of total, 34% of live births and 43% of those admitted to neonatal intensive unit). The causes of death were: 16 therapeutic effort limitation in delivery room, 8 therapeutic effort limitation in neonatal ward, 7 nosocomial sepsis, 7 NEC, 4 respiratory problems, and 8 of unknown cause. There were no survivors below 24 gestational weeks. Of the 26 survivors, 4 had major neurological disorders, and 11 with a normal neurological outcome. No significant statistical differences were found in the mortality between the two five-year periods analysed.

Conclusions: The peri-viability has important clinical and ethical problems for neonatologist.

Keywords: Extreme prematurity; Limit of viability; Límite de la viabilidad; Prematuridad extrema; Supervivencia; Survival.