Neonatal periviability

Abstract

Prematurity is the leading cause of death worldwide in children under 5 years of age. Those who manage to survive and adapt to extrauterine life, depending on the degree of the condition, may be condemned to a long life of disabilities and reduced quality of life. When the delivery is extremely preterm, the degree of compromise is much greater. In these cases, the attending physician should consider two scenarios: to be aggressive and give the newborn every chance, in the hope that he or she will survive without major compromise, or to provide minimal supportive management, accepting that the possibility of death is high and the risk of disability too great to condemn the entire family to deal with the problem. The decision is not easy, since physicians have different views of the problem, sometimes based on erroneous information. With this in mind, we review the issue of periviability, showing evidence of the short, medium and long term outcomes of these neonates.