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Change in the Limit of Viability of Fetal Infants

Journal of the Korean Pediatric Society 2003;46(12):1194-1199.
Published online December 15, 2003.
Change in the Limit of Viability of Fetal Infants
Chang Won Choi1, Jong Hee Hwang1, Jae Won Shim2, Sung Sin Kim3, Sun Young Ko4, Eun Kyung Lee4, Yun Sil Chang2, Won Soon Park2
1Department of Pediatrics, Samsung Medical Center, College of Medicine, Sungkyunkwan University, Seoul, Korea
2Department of Pediatrics, Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea
3Department of Pediatrics, Puchon Hospital, College of Medicine, Soon Chun Hyang University, Puchon, Korea
4Department of Pediatrics, Samsung Cheil Hospital, College of Medicine, Sungkyunkwan University, Seoul, Korea
태아 영아의 생존 한계의 변화에 대한 연구
최창원1, 황종희1, 심재원2, 김성신3, 고선영4, 이은경4, 장윤실2, 박원순2
1성균관대학교 의과대학 삼성서울병원 소아과
2성균관대학교 의과대학 강북삼성병원 소아과
3순천향대학교 의과대학 부천병원 소아과
4성균관대학교 의과대학 삼성제일병원 소아과
Correspondence: 
Won Soon Park, Email: wspark@smc.samsung.co.kr
Abstract
Purpose
: To determine the change in the limit of viability in fetal infants and the incidence of major complications in neonatal intensive care unit(NICU) at Samsung Medical Center(SMC).
Methods
: Sevety-three infants weighing less than 800 g at birth and 117 infants born earlier than 27 weeks gestational age, who were admitted to NICU at SMC between November 1994 and December 2002, were enrolled. Their medical records were reviewed with a focus on the survival and major complications, including chronic lung disease, retinopathy of prematurity, intraventricular hemorrhage, and periventricular leukomalacia. The limit of viability in fetal infants was defined as the birth weight or gestational age at which a 50% survival rate is reached and the incidence of major complications were compared by period(period I : Nov. 1994-Dec. 1998, period II : Jan. 1999-Dec. 2002).
Results
: The limit of viability in fetal infants was markedly lowered from birth weight range of 800-900 g or gestational age range of 26+0-26+6 weeks in period I to birth weight range of 600-700 g or gestational age range of 24+0-24+6 weeks in period II. The incidence rates of major complications at the limit of viability were all less than 50% in period II. There was no definite trend toward increased incidence of major complications as birth weight get smaller and gestational age get younger.
Conclusion
: Our results indicate that at present, fetal infants whose body weight is over 600 g, or whose gestational age is over 24 weeks should be resuscitated vigorously. The risk of major complications at this birth weight or gestational age seems to be not greater than that at a bigger birth weight or an older gestational age.
Key Words: Viability, Survival rate, Fetal infants, Limit


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