Milligan J E, Shennan A T, Hoskins E M
Am J Obstet Gynecol. 1984 Mar 1;148(5):499-503. doi: 10.1016/0002-9378(84)90734-8.
With the rapid advances in perinatal intensive care and resultant changes in neonatal prognosis, it is often difficult for the medical personnel involved to know where application of such care is justified, whether major intervention for fetal reasons is warranted, or what information to give parents as to probable outcome. To aid in developing guidelines for these areas of concerns, 730 consecutive live births that occurred in a perinatal unit between 23 and 32 weeks' gestation were analyzed for mortality and long-term morbidity by gestational age at birth. Probability of a normal outcome varies considerably according to which method of analyzing outcome is used. With a greater than 50% probability of intact survival from 25 weeks' gestation and above, intervention for fetal reasons seems to be justified if indicated on purely medical grounds, although prolonged use of restricted resources at or below 25 weeks remains a concern.
随着围产期重症监护的迅速发展以及新生儿预后的相应变化，参与其中的医务人员常常难以确定这种护理的应用是否合理，是否有必要因胎儿原因进行重大干预，或者应该向父母提供哪些关于可能结果的信息。为了帮助制定针对这些关注领域的指南，我们对一家围产期单位在妊娠23至32周之间连续发生的730例活产进行了分析，以了解出生时胎龄与死亡率和长期发病率之间的关系。根据所使用的分析结果的方法不同，正常结局的概率差异很大。从妊娠25周及以上开始，完整存活的概率大于50%，因此，如果纯粹基于医学理由表明有必要，因胎儿原因进行干预似乎是合理的，不过在25周及以下长时间使用有限资源仍是一个令人担忧的问题。
