Improving obstetric estimation of outcomes of extremely premature neonates: an evolving challenge
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Daniel W. Skupski
Abstract
Aims: A clinically useful website at the US National Institutes of Child Health and Human Development (NICHD) uses an algorithm based on a recent publication to estimate peri-viable neonatal outcomes. This algorithm uses gestational age, ultrasound estimated fetal weight (EFW), fetal sex, and the use of antenatal corticosteroids as the basis for estimation of outcomes and when used after birth is superior to such estimation by gestational age alone. Because one might be tempted to use this algorithm with obstetric patients, we tested its clinical applicability.
Methods: We reviewed the literature using search terms relating to the above clinical factors. Next, we gathered data from the website. The range of outcomes for neonates was then estimated using the uncertainty derived for these clinical factors before birth from the literature review and the NICHD website algorithm.
Results: We found increased uncertainty for estimating outcomes, as a function of the greater uncertainty in knowledge of the clinical factors in obstetrics as opposed to neonatology.
Conclusions: The imprecision during the time before birth seriously restricts the obstetric use of the NICHD algorithm at this time. Refining the precision of the algorithm prior to birth is necessary.
©2010 by Walter de Gruyter Berlin New York
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- Roster of Perinatal Societies
- Roster of Perinatal Societies
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- The Declaration of Dubrovnik
- The prediction and prevention of preterm birth and its consequences: an unmet challenge to perinatal medicine, science and society
- Original articles – Obstetrics
- Women's attitudes to and perceptions of oral health and dental care during pregnancy
- Low circulating maternal adiponectin in patients with pyelonephritis: adiponectin at the crossroads of pregnancy and infection
- Improving obstetric estimation of outcomes of extremely premature neonates: an evolving challenge
- Atosiban vs. ritodrine as a tocolytic in external cephalic version at term: a prospective cohort study
- Evaluation of placental function using near infrared spectroscopy during fetal growth restriction
- Association between women's self-diagnosis of labor and labor duration after admission
- Amniotic fluid volume in intra-amniotic inflammation with and without culture-proven amniotic fluid infection in preterm premature rupture of membranes
- The prognosis of pregnancy conceived despite the presence of an intrauterine device (IUD)
- Takayasu's arteritis in pregnancy: review of literature and discussion
- Role of parental folate pathway single nucleotide polymorphisms in altering the susceptibility to neural tube defects in South India
- Original articles – Fetus
- Cholinergic signal activated renin angiotensin system associated with cardiovascular changes in the ovine fetus
- The potential of 4D sonography in the assessment of fetal neurobehavior – multicentric study in high-risk pregnancies
- Predictive value of pulse oximetry for the development of fetal acidosis
- Racial/ethnic disparities in infant mortality
- Original articles – Newborn
- Antenatal steroid treatment reduces childhood asthma risk in very low birth weight infants without bronchopulmonary dysplasia
- Roster of Perinatal Societies
- Roster of Perinatal Societies
- Congress Calendar
- Congress Calendar
