The obstetrician's dilemma during delivery of the very-low-birth-weight infant

Delivery of the premature infant weighing less than 1,500 g poses a significant dilemma for the obstetrician. First-discharge survival of 218 very-low-birth-weight infants was retrospectively analysed and the survival rate of infants with a birth weight of less than 800 g was found to be only 15%. If the birth-weight of the infant was between 800 g and 999 g or 1,000 g and 1,500 g, the survival rates were 49% and 84%, respectively. Although first-discharge survival is not the optimal end-point of fetal outcome, estimating the gestational weight before delivery will give the obstetrician an indication of potential survival when dealing with very-low-birth-weight infants. This knowledge is especially pertinent to the obstetrician when the decision whether or not to achieve a survivor at all costs has to be made.