The obstetric management in very-low-birth weight infants.

Eighty-three very-low-birth weight (VLBW) infants weighing between 500 g and 1,500 g were studied. The neonatal morbidity and mortality were 86.7% and 18.1%, respectively. Sixty-six point seven percent (8/12) of the infants weighing under 1,000 g suffered from a periventricular-intraventricular or intracranial hemorrhage (PVH/IVH) and their mortality rate was 50%. The incidence of PVH/IVH was 52.1%, and the mortality rate was 12.7% when the birth weight was between 1,000 g and 1,500 g. Forty-nine percent of the PVH/IVH took place on the first day of neonatal life, and 93% developed within 5 days after delivery. Cesarean section neither reduced the incidence of PVH/IVH nor increased the survival rate whether in cephalic or breech presentation. The incidence of PVH/IVH was not affected by type of presentation or the interval between the rupture of membranes and the delivery. Respiratory distress syndrome (RDS) and the requiring of a ventilator for ventilation significantly increased the incidence of PVH/IVH, while a low Apgar score (less than 3) at 5 minutes did not.