Perinatal care at the threshold of viability--from principles to practice.

Full Abstract

The threatened birth of an extremely-low-birth-weight (ELBW) and gestational age infant presents complex medical, social and ethical issues for the family and the health professionals. Improved survival may be accompanied by increased risks of chronic medical problems and neurodevelopmental disabilities. It is difficult to define "how small is too small" and to decide "how much is too much" in providing optimal management of the mother and infant when delivery takes place at the threshold of viability. An individualised prognostic strategy appears to be the most appropriate approach. Through a process of communication and value exploration between the well-meaning parents and well-intentioned physicians, the goal is to reach a consensual decision that respects parental authority and promotes physician beneficence, with the best interests of the infant placed in the centre of the analysis.

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Author information

Author/s: Ho, L Y (LY);

Affiliation: Department of Neonatology, Singapore General Hospital, Outram Road, Singapore 169608. gnehly(-atsign-)sgh.com.sg

Journal and publication information

Publication Type: Journal Article

Journal: Annals of the Academy of Medicine, Singapore (Ann Acad Med Singapore), published in Singapore. (Language: eng)

Reference: 2003-May; vol 32 (issue 3) : pp 362-75

Dates: Created 2003/07/11; Completed 2003/10/31; Revised 2004/11/17;

PMID: 12854380, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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