Abstract
An ethical dilemma exists regarding the delivery room resuscitation of the FI. To determine current practice and outcome, we evaluated all 32 inborn FI born from 7/82-6/83[mean BW 604gm (range 300-740gm), mean GA 24.6wks (range 21-30wks)].
Deaths in the delivery room occurred at a mean of 1 2/3 hrs and in the NICU at a mean of 4 hrs. Cause of death in 12/24 was fetal infection associated with chorioamnionitis. All 8 survivors were intubated at birth; 7 had RDS and/or BPD, 5 required respiratory support for >2 mo.(range 2-12) and O2 for 2-18 mo. 5 had sepsis and 6 had intraventricular bleeds (1 Gr.I, 3 Gr.II, and 2 Gr.IV). Mean hospital stay was 168 days(range 92-365)with cost of care $175,302(range $80,000-$400,000). 3 remain in chronic care facilities; 5 require social welfare.
These data confirm the enormous wastage and long term morbidity of the FI. With current practice, survival is feasible only with immediate intubation of infants ±700gm. Rather than extending life supportive measures to even smaller infants, emphasis should be on recognition and treatment of chorioamnionitis.
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Hack, M., Fanaroff, A. A PERINATAL DILEMMA-MANAGEMENT OF THE LIVEBORN FETAL INFANT(FI) (BW <750gm, GA >20wks). Pediatr Res 18 (Suppl 4), 324 (1984). https://doi.org/10.1203/00006450-198404001-01389
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DOI: https://doi.org/10.1203/00006450-198404001-01389
