Earliest viable gestational age?

[everthesame, LPN, LVN]

What is the earliest gestational age you have seen survive?

I ask this question because a co-worker told a high risk mom who is currently 19 wks that she only has to make it another week for the baby to be viable. This co-worker insists that her own child was born at 20 weeks and is just fine today. I work in a prison now, but when I worked in a hospital, I don't think NICU even went on the delivery of a 20 weeker. I am not thrilled that my co-worker is telling this mom that if she delivers next week her baby could possibly survive...especially right after I told the mom something different when she asked me how early a baby could survive.

Have any of you ever seen a 20 weeker survive?

[NJNICUCCRN]

Never a 20 weeker! The earliest i have seen is 23-plus. We are not aggressive with under 24 weeks unless the baby is very active at birth.

[prmenrs, RN]

@ 20 weeks, the baby has no alveoli. Therefore, s/he cannot breathe. Perhaps googling fetal development might help your co-worker understand why a 20 wkr can't survive. I'd be willing to bet her baby's gestation wasn't 20 wks.

[NeoNurseTX, RN]

We've had a few 22 weekers survive maybe a week. Other than that, no way.

[everthesame, LPN, LVN]

Thanks for the responses. I worked for a very short time in NICU and the earliest I ever saw was a 23+5 wk and he will never be a "normal" child.

My co-worker is adamant about the gestational age of her son to the point that she becomes hostile when you ask her is she is sure about the dates. My guess is that she misunderstood something that was told to her all those years ago. I am sure there was a lot of info for her to take in when her baby was born and admitted to the NICU.

[HappyBunnyNurse]

The misunderstanding may have come from an incorrect estimation of due date. Unless the pregnancy is the result of IVF then you just can't be sure. Sometimes a 23 weeker will on examination be a bit older. Sadly, sometimes an expected 26 weeker will actually be less. I am so glad I'm not a doc and don't have to make these calls. The important thing for your pt to understand is that "viable" doesn't necessarily mean "ok"

[FlyingScot, RN]

Many years ago we had a 22 weeker (confirmed) because we had a doctor who would intubate a potato if he thought he could fit the tube in. Had a 2.0 ETT that we had to suction with a 3.5fr UAC because the 5fr suction catheter would not fit. What's worse is at the time the current thought on skin protection was to dust the micro-preemies with Nystatin powder (glad that went away). She literally looked like a chicken leg waiting to go into the deep fryer. She was also meaner than a snake that little thing. I guess it was a good thing though since she somehow managed to survive with her only problem being ROP.

[Elvish, BSN, DNP, RN, NP]

Our NICU attends 20wk deliveries on the offchance that the dates are off and baby might require resuscitation. But they always discuss beforehand that before about 23 weeks, there is really nothing to be done except keep baby comfortable.

[soprano3]

The youngest preemie I've ever seen survive is 23 4/7 weeks, she did quite well.

everthesame said:

What is the earliest gestational age you have seen survive?

I ask this question because a co-worker told a high risk mom who is currently 19 wks that she only has to make it another week for the baby to be viable. This co-worker insists that her own child was born at 20 weeks and is just fine today. I work in a prison now, but when I worked in a hospital, I don't think NICU even went on the delivery of a 20 weeker. I am not thrilled that my co-worker is telling this mom that if she delivers next week her baby could possibly survive...especially right after I told the mom something different when she asked me how early a baby could survive.

Have any of you ever seen a 20 weeker survive?

[TiffyRN, BSN, PhD]

Amillia Sonja Taylor was in the news a few years ago as the youngest gestational age infant to ever survive to discharge. She was reported as an in-vitro infant born at 21wks 6 days. However it has never been clear if they were counting from actual conception or the more traditional way which adds 2 weeks to the actual time from conception. If they were counting from date of conception then Amillia would be classified by most neonatologists as 23wks 6 days which is by no means a record. I've seen several 23 weekers in our unit survive to discharge. There have been several reports of infants less than 23 weeks (though I've never heard of any truly

It's usually useless to argue with people about points like this and sadly they spread this information very widely. There is a section on pre-term birth on wikipedia that discusses notable premature and small infants. At nearly the end of the page there is the paragraph I just mentioned. Needless to say if your co-worker had an infant at 20 weeks, it most likely would be in medical literature (if not out in the general media).

[morte, LPN, LVN]

I am wondering if there is some social consideration in her insistence that the infant was only 20 weeks?

[TiffyRN, BSN, PhD]

morte said:

I am wondering if there is some social consideration in her insistence that the infant was only 20 weeks?

Absolutely possible. My husband (also NICU nurse) admitted an infant that by mom's dates was 24 weeks (so of course everyone was geared up for quite the difficult & extensive admission). When the infant came out at 1800 grams and screaming vigorously the MD was happy to inform the mother that though her infant was premature and would be admitted the MD felt the hospitalization would not be long as she estimated the infant's gestational age at 34 weeks. The mom then looked at the "dad" and started yelling, "no, 24 weeks, 24 weeks!". Apparently dad had not been back from service in the middle east 34 weeks ago.