Arora Kavita S, Miller Emily S
Director of Quality, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH.
Fellow in the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL.
Obstet Gynecol Surv. 2014 Jun;69(6):359-68. doi: 10.1097/OGX.0000000000000076.
Periviable birth poses numerous clinical and ethical challenges for the practicing clinician. We review the data surrounding the administration of corticosteroids for fetal lung maturity, antibiotics in the case of preterm premature rupture of membranes, magnesium sulfate for cerebral palsy prophylaxis, fetal monitoring, and cesarean delivery. The ethical complexities of patient counseling are also reviewed with a recommendation toward shared decision making between patient and physician.
对于执业临床医生而言，近可存活儿分娩带来了众多临床和伦理挑战。我们回顾了有关使用皮质类固醇促进胎儿肺成熟、胎膜早破时使用抗生素、使用硫酸镁预防脑瘫、胎儿监测以及剖宫产的数据。还回顾了患者咨询中的伦理复杂性，并建议患者与医生共同做出决策。
