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Published online by Cambridge University Press:  12 September 2013

Department of Fetal Medicine, The Rosie Hospital, Cambridge CB2 0QQ, UK.
Department of Fetal Medicine, The Rosie Hospital, Cambridge CB2 0QQ, UK.
Jeremy C Brockelsby, Department of Fetal Medicine, The Rosie Hospital, Cambridge CB2 0QQ, UK. Email:


Delivery of the infant at the limits of viability is a complex challenge for the obstetrician. Despite the best efforts of obstetricians to prolong gestation beyond 23–24 weeks, there may be compelling reasons to intervene in an ongoing pregnancy for maternal benefit (for example in severe pre-eclampsia or placental abruption) or delivery may be considered for foetal reasons. However, the majority of deliveries at the limits of viability will be the consequence of spontaneous pre-term labour, leaving the obstetrician with the difficult and time-pressured decisions regarding which, if any, interventions may be of benefit to foetal or maternal outcome. In most European countries, the rate of pre-term birth continues to rise, making such clinical scenarios increasingly common.

Review Article
Copyright © Cambridge University Press 2013 

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