Manejo perinatal en el límite de la viabilidad. Propuestas de abordaje en un hospital terciario

Abstract

This article aims to provide a clinical practice guideline on perinatal management in fetuses/neonates at the threshold of viability (below a gestational age of 256/7 weeks). We reviewed the main literature published in the last few years. On the basis of outcomes in morbidity and mortality in our hospital and consensus with neonatologists, we established a management protocol in our center. We propose a protocol in which, gestational age or, in its absence, birth weight are used to determine the kind of prenatal care provided, the need for neonatal transport, use of prenatal corticosteroids, mode of delivery and neonatal resuscitation. This protocol is applied in close collaboration with neonatologists and with parents’ participation in the decision to treat.