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The management and counseling of women at risk for delivering fetuses of periviable gestational age (defined as 20 0/7 weeks through 25 6/7 weeks) is multifaceted. Fetal survival rates range from 0% at 20 weeks to >50% at 25 weeks. Preferably, periviable births should occur in tertiary care centers with maternal-fetal medicine and neonatal intensive care services.
A recent workshop involving specialists in maternal-fetal medicine and perinatal pediatrics encompassed several issues regarding periviable delivery. Key recommendations for obstetric interventions by gestational age are as follows:
Not recommended: Corticosteroids, tocolytics, magnesium sulfate for neuroprotection, antibiotics for group B streptococcus (GBS) prophylaxi…