Lawin-O'Brien, AR;
Dall'Asta, A;
Knight, C;
Sankaran, S;
Scala, C;
Khalil, A;
Bhide, A;
Heggarty, S;
Rakow, A;
Pasupathy, D;
et al.
Lawin-O'Brien, AR; Dall'Asta, A; Knight, C; Sankaran, S; Scala, C; Khalil, A; Bhide, A; Heggarty, S; Rakow, A; Pasupathy, D; Papageorghiou, AT; Lees, C
(2016)
Short-term outcome of periviable small-for-gestational-age babies: is our counseling up to date?
Ultrasound in Obstetrics & Gynecology, 48 (5).
pp. 636-641.
ISSN 1469-0705
https://doi.org/10.1002/uog.15973
SGUL Authors: Papageorghiou, Aris Khalil, Asma
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Abstract
OBJECTIVE: There is limited data for counseling and management of periviable small for gestational age fetuses. We aim to investigate short term outcome in periviable SGA fetuses and relate this to the underlying cause. METHODS: Retrospective database study conduced in three London tertiary fetal medicine centres between 2000 and 2015. We included viable singleton pregnancies with abdominal circumference ≤ 3rd percentile between 22 + 0 and 25 + 6 weeks. Data obtained included biometry and placental anomalies, uterine and fetal Doppler and neonatal outcome. We excluded those cases with demonstrated structural abnormalities, proven or suspected abnormal karyotype or genetic syndromes. Cases were categorised as uteroplacental insufficiency, evidence of placental damage with normal uterine artery Doppler, viral infection or unclassifiable. RESULTS: 245 cases were included. At diagnosis 201/245 (82%) were categorised as uteroplacental; 13/245 (5.3%) as suspected placental and 30 could not be assigned to any of these categories. Overall, 101/245 (41%) survived; the rate of in utero fetal demise was 89/245 (36%), 22/245 (9%) were neonatal deaths and 33/245 (14%) of pregnancies were terminated. The diagnosis to delivery interval was 8.1 weeks in those that survived, 2.7 weeks in those that died in utero and 3.9 weeks in those that died neonatally. CONCLUSIONS: Over 90% of periviable SGA cases are associated with uteroplacental insufficiency or intraplacental damage. Survival is related to gestation at delivery, with outcomes better than might be assumed at diagnosis and some pregnancies reaching term.
Item Type: | Article | ||||||||
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Additional Information: | This is the peer reviewed version of the following article: Lawin-O'Brien, A.R., Dall'Asta, A., Knight, C., Sankaran, S., Scala, C., Khalil, A., Bhide, A., Heggarty, S., Rakow, A., Pasupathy, D., Papageorghiou, A.T. and Lees, C. (2016), Short term outcome of Periviable SGA: Is our counseling up to date?. Ultrasound Obstet Gynecol. 48: 636–641., which has been published in final form at doi:10.1002/uog.15973. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. | ||||||||
Keywords: | antenatal counseling, fetal complications, iatrogenic preterm delivery, intrauterine growth restriction, neonatal intensive care unit, periviable SGA, antenatal counseling, fetal complications, iatrogenic preterm delivery, intrauterine growth restriction, neonatal intensive care unit, periviable SGA, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Institute of Medical & Biomedical Education (IMBE) Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE ) Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) > Vascular (INCCVA) |
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Journal or Publication Title: | Ultrasound in Obstetrics & Gynecology | ||||||||
ISSN: | 1469-0705 | ||||||||
Language: | ENG | ||||||||
Dates: |
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Publisher License: | Publisher's own licence | ||||||||
PubMed ID: | 27222216 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/108120 | ||||||||
Publisher's version: | https://doi.org/10.1002/uog.15973 |
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