title: Ethical dimensions of periviability.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medical Center, New York, NY 10021, USA. dwskupsk@med.cornell.edu
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Skupski
authors.forename: Frank A
authors.initials: FA
authors.lastname: Chervenak
authors.forename: Laurence B
authors.initials: LB
authors.lastname: McCullough
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bancalari
authors.forename: Dominique
authors.initials: D
authors.lastname: Haumont
authors.forename: Umberto
authors.initials: U
authors.lastname: Simeoni
authors.forename: Ola
authors.initials: O
authors.lastname: Saugstad
authors.forename: Steven
authors.initials: S
authors.lastname: Donn
authors.forename: Birgit
authors.initials: B
authors.lastname: Arabin
authors.forename: Anne
authors.initials: A
authors.lastname: Greenough
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Donzelli
authors.forename: Malcolm
authors.initials: M
authors.lastname: Levene
authors.forename: Cihat
authors.initials: C
authors.lastname: Sen
authors.forename: Xavier
authors.initials: X
authors.lastname: Carbonell
authors.forename: Joachim W
authors.initials: JW
authors.lastname: Dudenhausen
authors.forename: Radu
authors.initials: R
authors.lastname: Vladareanu
authors.forename: Aris
authors.initials: A
authors.lastname: Antsaklis
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Papp
authors.forename: Mehmet
authors.initials: M
authors.lastname: Aksit
authors.forename: Manuel
authors.initials: M
authors.lastname: Carrapato
mesh_terms: D003657:Decision Making / Q000941:ethics*; D004992:Ethics, Medical; D005260:Female; D005328:Fetal Viability; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011247:Pregnancy