Feasibility of pre-extreme pre-extreme newborn in a public hospital in the year 2015

Abstract

Introduction: Advances in perinatology in recent decades have made possible the survival of increasingly preterm newborns (NB). Extreme prematurity is defined as gestational age less than 28 weeks according to the World Health Organization (WHO) and gestational age of neonatal average survival has changed from 30 to 31 weeks in the 60s to 23 to 24 weeks in the last 20 years. Objective: To evaluate the feasibility of extreme preterm infants in a hospital unit. Methods: Retrospective and quantitative longitudinal observational study, done with the analysis of records of newborns with GI less than 32 weeks, born between January and December 2015, since this is the first year of the residency performed by the students in neonatology. Results / Discussion: We analyzed charts of 65 newborns with gestational age less than 32 weeks and 61 pregnant women, 4 of whom had twin pregnancies. With a mean maternal age of 26.4 years, 35 mothers were resident in the city of Goiânia (57.37%), with an average of 3.5 consultations per mother who underwent prenatal care and the antenatal corticosteroid was performed in 46 patients (75 , 40%). A ruptured amniotic sac greater than 18 hours was observed in 23 patients (37.70%). The preferred route of delivery was vaginal in 37 pregnant women (60.65%) versus 24 caesarean sections (39.34%). Regarding the birth data, we observed that the mean gestational age was 28 wk and 4 days, with an average weight of 1070 grams, 8 of which were classified as small for gestational age (12.30%) and none presented weight above the percentile 90 when analyzed by the Lubchenco chart. The fifth minute APGAR was superior to 7 in 46 patients (70.76%), 5 to 7 in 10 neonates (15.38%) and less than 5 in 9 newborns (13.8%). The mean overall number of days of hospitalization was 39.13 days. Conclusion: The limit of neonatal viability found in the year 2015 in the Hospital and Maternity Dona Iris was 28 weeks, still higher than expected when comparing large centers and rates of developed countries, but is comparable to underdeveloped and developing countries.