Ethical dimensions of periviability.
The birth of neonates at the limits of viability, or periviability, poses numerous challenges to health care providers and to systems of care, and the care of these pregnancies and neonates is fraught with ethical controversies. This statement summarizes the ethical principles involved in the care of periviable pregnancies and neonates, and provides expert clinical opinion about the numerous challenges posed by this problem around the world. Topics addressed include a summary of the published experience, an ethical framework, translating neonatal outcome data to the obstetric arena, management as a trial of intervention, referral to tertiary centers, neonatal resuscitation, cesarean delivery for fetal indication, and limits on life-sustaining neonatal treatment.
Skupski
Daniel W
DW
Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY 10021, USA. dwskupsk@med.cornell.edu
Chervenak
Frank A
FA
McCullough
Laurence B
LB
Bancalari
Eduardo
E
Haumont
Dominique
D
Simeoni
Umberto
U
Saugstad
Ola
O
Donn
Steven
S
Arabin
Birgit
B
Greenough
Anne
A
Donzelli
Gianpaolo
G
Levene
Malcolm
M
Sen
Cihat
C
Carbonell
Xavier
X
Dudenhausen
Joachim W
JW
Vladareanu
Radu
R
Antsaklis
Aris
A
Papp
Zoltan
Z
Aksit
Mehmet
M
Carrapato
Manuel
M
D003657:Decision Making / Q000941:ethics*; D004992:Ethics, Medical; D005260:Female; D005328:Fetal Viability; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy