Periviable birth: Workshop summary

The findings of a Joint Workshop held by leading organizations in obstetric and pediatric/neonatal care were recently published in multiple journals and contains summaries and recommendations about obstetric and neonatal management. Highlights of this report:

  1. The term perviable birth was used in the report to refer to delivery occurring from 20 0/7 to 25 6/7 weeks of gestation.
  2. Tocolytic agents have not shown to consistently demonstrate pregnancy prolongation beyond 24–48 hours or newborn benefits, and there are no studies on women with preterm labor or PROM at 20–25 weeks of gestation.
  3. No data are available about the benefits of magnesium sulfate between 20 – 25 weeks.
  4. Antenatal corticosteroid therapy likely has benefits as early as 22 – 23 weeks gestation.
  5. Currently available data do not support routine cesarean delivery to improve perinatal mortality or neurological outcomes for periviable infants.
  6. A team approach to counseling is recommended. Counseling should be a bidirectional, collaborative and ongoing process.
  7. Counseling should include discussion of the benefits and risks of various maternal and neonatal interventions at the time of counseling.
  8. Gestational age along and current predictive algorithms do not provide information that is sufficiently accurate or generalizable. 
  9. Aggressive newborn resuscitation is recommended for infants born at 23 0/7 weeks or greater gestation. 

Periviable birth. Executive summary of a joint workshop. Raju et al, 2014.