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The Youngest Survivor with Gestational Age of 21⁵/₇ Weeks

Se In Sung1, So Yoon Ahn1, Hye Soo Yoo1

  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|December 8, 2017
PubMed

Insights

Extremely premature infants born at 21 weeks gestation can survive with good outcomes. This case highlights the importance of individualized resuscitation decisions for periviable infants.

Area of Science:

  • Neonatal medicine
  • Perinatalogy
  • Reproductive medicine

Background:

  • Individualized decisions for resuscitating extremely low gestational age (GA) infants are crucial, based on antenatal counseling.
  • Gestational age of 22 0/7–23 6/7 weeks is typically considered the lower limit for selective resuscitation.
  • Infants born below this threshold have a low survival rate, with rare reports of survivors.

Observation:

  • A female infant, a twin conceived via in vitro fertilization, was born at a GA of 21 5/7 weeks.
  • Resuscitation was initiated due to strong parental wishes following antenatal counseling.
  • The infant survived and is currently 43 months old.

Findings:

  • This case represents the youngest reported survivor of extreme prematurity at 21 5/7 weeks GA.
  • The infant demonstrates a fairly good neurodevelopmental outcome at 43 months of age.

Implications:

  • This case challenges the traditional lower limits for neonatal resuscitation.
  • It underscores the potential for survival and positive outcomes in extremely preterm infants with individualized care.
  • Parental involvement and counseling are vital in managing periviable births.

Keywords:
Case ReportsExtremely Low Gestational Age InfantResuscitation

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