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Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center

Korean Journal of Pediatrics 2005;48(9):939-945.
Published online September 15, 2005.
Outcomes and Management of Fetal Infants with Birth Weight Below 500 g at a Tertiary Center
Yun Sil Chang1, Yu Jin Kim1, Soo Hyun Koo1, Jang Hoon Lee1, Jong Hee Hwang2, Chang Won Choi3, Jae Won Shim4, Sung Shin Kim5, Sun Young Ko6, Eun Kyung Lee7, Won Soon Park1
1Department of Pediatrics, Samsung Medical Center, Samsung Cheil Hospital, Seoul, Korea
2Department of Pediatrics, Ilsan Paik Hospital, Inje University School of Medicine, Koyang, Korea
3Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
4Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan Universtiy School of Medicine, Seoul, Korea
5Department of Pediatrics, Bucheon Hospital, Soonchunhyang University, College of Medicine, Bucheon, Korea
6Department of Pediatrics, Samsung Cheil Hospital, Sungkyunkwan Universtiy School of Medicine, Seoul, Korea
7Department of Pediatrics, Kangnam Cha Hospital, Pochon Cha University, Seoul, Korea
출생체중 500 g 미만의 태아영아 치료성적 및 치료의 실제
장윤식1, 김유진1, 구수현1, 이장훈1, 황종희2, 최창원3, 심재원4, 김성신5, 고선영6, 이은경7, 박원순1
1성균관대학교 의과대학 삼성서울병원 소아과
2인제대학교 의과대학 일산백병원 소아과
3분당서울대학교병원 소아과
4성균관대학교 의과대학 강북삼성병원 소아과
5순천향대학교 의과대학 부천병원 소아과
6성균관대학교 의과대학 삼성제일병원 소아과
7포천중문의과대학교 강남차병원 소아과
Correspondence: 
Yun Sil Chang, Email: yschang@smc.samsung.co.kr
Abstract
Purpose
: The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors.
Methods
: We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths.
Results
: Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was 23+3 among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age(24+2±1+3 vs. 25+4±2+3) and birth weight(424±17 vs. 453±19)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively.
Conclusion
: Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.
Key Words: Fetal infants , Viability , Survival rate


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