Progress on management of periviable extremely premature infants / 中华围产医学杂志

ABSTRACT

Periviable extremely preterm infant (PEPI) refers to preterm infants born on the border of viability, mainly those with gestational age less than 24 weeks or birth weight less than 500 g. PEPI has increased in the past decades, and about half of the survivors live without severe neurodevelopmental impairment. The management of PEPI remains one of the most complex fields in perinatal-neonatal medicine. Active interventions can reduce the risk of morbidity and mortality in PEPI during early life and short-term follow-up after discharge without increasing the risk of neurodevelopmental impairment. Clinical decision-making about PEPI should not be restricted to population-based prenatal data but should mainly be based on postnatal individual characteristics and conditions. Parents should make an informed choice after detailed consultation with their physician. When the prognosis is uncertain, resuscitation and intensive care could be given and reassessed subsequently. Current interventions or treatments of PEPI refer to strategies for infants born at 24-27 gestational weeks, which need to be refined in practice.