title: A moving line in the sand: a review of obstetric management surrounding periviability.
abstract: 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.
authors.affiliation: Director of Quality, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Cleveland, OH.
authors.forename: Kavita S
authors.initials: KS
authors.lastname: Arora
authors.affiliation: Fellow in the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Miller
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000517:prevention & control; D002585:Cesarean Section; D037001:Directive Counseling / Q000941:ethics*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy; D006801:Humans; D062071:Infant, Extremely Premature; D008278:Magnesium Sulfate / Q000627:therapeutic use; D010353:Patient Education as Topic; D010358:Patient Participation; D011247:Pregnancy; D047928:Premature Birth / Q000401:mortality / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D008278:Magnesium Sulfate