Abstract
ABSTRACT. In the 4 years 1977 to 1980, 375 infants weighing 501–1500g were admitted to the neonatal unit of the Queen Victoria Medical Centre. Overall neonatal survival was 79%; 56% of infants weighing 501–1000g and 89% of infants weighing 1001–1500g survived. Four post neonatal deaths occurred in hospital. Perinatal factors associated with decreased survival were indicators of perinatal asphyxia, thus demonstrating the imortance of the prevention of this condition in the management of early preterm labour. The survival rate for infants born after Caesarean section was significantly higher than those born after vaginal delivery for the whole study group but not among the smallest infants weighing ≤ 1000g. The two most common causes of respiratory failure were hyaline membrane disease and recurrent apnoea of prematurity. Two hundred and forty-seven (68%) infants required assisted ventilation, of whom 116 (67%) survived. Although the majority of infants could be ventilated successfully with low peak airway and positive and expiratory pressures, the prevention of air leak and bronchopulmonary dysplasia remain a therapeutic challenge. As we now expect the majority of very low birthweight infants to survive, documentation of short and long term morbidities are essential in order to determine how much greater an improvement can be expected by the use of new innovations in perinatal care.
Published Version
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