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11-06-2012 at 6:11 PM
Eyre2
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Viability...

Ive seen the word "Viability" alot and I just want to check a few things...when exactly is LO viable? And what exactly does that mean? I know chances of survival go up after 23 or 24 weeks, but baby still needs to bake right?!

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11-06-2012 at 6:15 PM
RussianMom...
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it means a baby can survive outside of the womb via machines.. which is usually 24 or 27 weeks, I forget.

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11-06-2012 at 6:17 PM
onlymeggan
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Some say 23 weeks but I've usually heard V-day is 24 weeks.  Basically, prior to that the hospital won't even attempt to save the baby.  After v-day the chance of survival is there, small, but there.  Yes, Yes, Yes the baby needs to keep baking.  Full term is the place to be if at all possible.  :)

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11-06-2012 at 6:18 PM
mommysange...
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It simply means they baby has a small chance of surviving outside the womb if it were to be born now. Yes the baby needs to keep baking until at least 36 weeks to be healthy. Even babies born after 23 weeks may not survive but a miscarriage will not happen. It will be born but whether or not is survives varies. Some miracle babies have made it with all our technology. I posted about it today. I've had several miscarriages and this is a big milestone for me :) I know there is some chance that if something goes wrong they might be able to save him. The longer the baby bakes the more likely survival is.
11-06-2012 at 6:48 PM
bdutton000...
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The smallest chance now is at 20 weeks with it being about 4-5% that bay will live. 24 weeks is when they start giving the best chances though. Also from everything I've seen girls are more likely to survive before 24 weeks then boys, they "fight" more.

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11-06-2012 at 6:51 PM
GeeksWithS...
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28 weeks is considered by many the minimal Viability with good chances of success according to my doctor. Before that its very iffy because of the lung development and everything else. The way my doctor put it was 28 weeks is minimal, 34 weeks is safe minimal (little complications) and 36 is the ideal minimal.

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11-06-2012 at 6:57 PM
InkedMegs
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My MIL works in a NICU.  She goes with 24 weeks and does not buy anyone baby clothes/things until the mother is 24 weeks.  She will not buy me or baby anything baby-related for two more weeks.




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11-06-2012 at 8:06 PM
Lariah14
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bdutton0005:
The smallest chance now is at 20 weeks with it being about 4-5% that bay will live. 24 weeks is when they start giving the best chances though. Also from everything I've seen girls are more likely to survive before 24 weeks then boys, they "fight" more.

Boys areborn with less developed lungs, so the chance of survival is lower- they don't "fight" less. That's pretty insulting.  


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11-06-2012 at 8:20 PM
nola78
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Lariah14:

bdutton0005:
The smallest chance now is at 20 weeks with it being about 4-5% that bay will live. 24 weeks is when they start giving the best chances though. Also from everything I've seen girls are more likely to survive before 24 weeks then boys, they "fight" more.

Boys areborn with less developed lungs, so the chance of survival is lower- they don't "fight" less. That's pretty insulting.  

My son was born at 21 weeks.  Survival at 21 weeks is 0%.   Your whole "fight" comment is pretty distasteful.  


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11-06-2012 at 8:27 PM
philfemgal
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Usually "viability" is used to refer to the point at which a baby who is born at that gestation has about a 50% chance of survival.  That line now is 24 weeks.  23 weeks, I believe, is the earliest which some NICUs will take a baby and try to provide life-saving treatment, though chances the baby will live at 23 weeks are substantially less than 50%.

 http://en.wikipedia.org/wiki/Fetal_viability

bdutton0005:
The smallest chance now is at 20 weeks with it being about 4-5% that bay will live. 24 weeks is when they start giving the best chances though. Also from everything I've seen girls are more likely to survive before 24 weeks then boys, they "fight" more.

I can't find any information about there ever having been a 20 week baby surviving.  (20 weeks gestation you mean, right?)  Do you have a link for this?  The earliest I have ever seen even claimed by a news source is something like very late 21 weeks or very early 22 weeks, but the pregnancy dating in those cases if often contested.

I'd LOVE it to be the case that there was a 4-5% chance at 20 weeks as we are counting down the days to viability given we lost a baby in my last pregnancy at 18.5 weeks, but I have just never seen anything indicating that is the case.


 

mommysangels:
It simply means they baby has a small chance of surviving outside the womb if it were to be born now. Yes the baby needs to keep baking until at least 36 weeks to be healthy. Even babies born after 23 weeks may not survive but a miscarriage will not happen. It will be born but whether or not is survives varies. Some miracle babies have made it with all our technology. I posted about it today. I've had several miscarriages and this is a big milestone for me :) I know there is some chance that if something goes wrong they might be able to save him. The longer the baby bakes the more likely survival is.

Maybe I'm just misunderstanding what you mean by the bolded, but whether a baby is "born" or "miscarried" really has nothing to do with the 23 week or 24 week line.  I'm not sure really at what point in pregnancy a "miscarriage" becomes a "birth". At 20 weeks the term miscarriage is no longer technically used; a loss will usually then be referred to as a stillbirth.  Technically, though, when preterm labor is the cause of the loss a baby may be born alive even a few weeks before 20 weeks.  (At least, when I went into labor at 18.5 weeks and was waiting to deliver we were told the baby might be born alive and they would tell us immediately if there was any sign of a heartbeat, though of course there was no chance she would live more than a few minutes.)


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11-06-2012 at 8:43 PM
mommysange...
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I just meant that the baby will be born at that time instead of just bleeding it out. The latest miscarriage I had was at 14 weeks. I had to have a d&c. I didn't bleed but the baby wasn't breathing either so yeah a still birth. I should have just said that. Just glad to be this far along and I know now that it is a 50% chance of survival. My dr just said a small chance so I wasn't sure how small of a chance. Good luck to you all :)
11-06-2012 at 9:11 PM
SockMonkey...
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onlymeggan:
Some say 23 weeks but I've usually heard V-day is 24 weeks.  Basically, prior to that the hospital won't even attempt to save the baby.  After v-day the chance of survival is there, small, but there.  Yes, Yes, Yes the baby needs to keep baking.  Full term is the place to be if at all possible.  :)

my first set of twins were born 23w1d and 23w2d and they would not do anything to save them once my water broke.  24 weeks is when the rate starts to go up and they have some chance.


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11-06-2012 at 11:35 PM
LittleLuvB...
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SockMonkeySam:
my first set of twins were born 23w1d and 23w2d and they would not do anything to save them once my water broke. 24 weeks is when the rate starts to go up and they have some chance.


That is awful and a horrible disservice to you and your twins, I am so sorry for your loss... a woman on our BMB gave birth at 23w4d and they fought incredibly hard to save her, but lost the fight after a week. Heartbreaking...

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11-07-2012 at 2:09 AM
kelly321
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philfemgal:

Usually "viability" is used to refer to the point at which a baby who is born at that gestation has about a 50% chance of survival.  That line now is 24 weeks.  23 weeks, I believe, is the earliest which some NICUs will take a baby and try to provide life-saving treatment, though chances the baby will live at 23 weeks are substantially less than 50%.

This. A girl I went to high school with had twin girls at 23w2d last year. They're now almost a year old, have been at home for almost 6 months, and are being weaned off of O2. It really is a miracle that they both survived, but at around 23w is when there is at least a chance of survival. It depends on the particular baby and whether there's enough surfactant in the lungs, among many other factors. My Mayo Clinic book says chances of survival at 24w are about 50%.

And SockMonkey, I'm surprised they didn't do anything for your twins. I'm not trying to imply that they would have survived with intervention since the chances at that point are very low, but it seems that most NICUs I've heard of have moved to starting intervention attempts at 23w.



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11-07-2012 at 2:58 AM
ashleyndan...
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I work in a nursery, and we consider viability to be 25 weeks.  However, even early ultrasounds can be off by up to two weeks.  Our policy is that if the baby weighs at least 400 grams (14 ounces) we can try to resuscitate.  If the baby is smaller than this, we don't have supplies that are small enough to help the baby survive

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11-07-2012 at 9:20 AM
TMWarren85
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ashleyndaniel:
I work in a nursery, and we consider viability to be 25 weeks.  However, even early ultrasounds can be off by up to two weeks.  Our policy is that if the baby weighs at least 400 grams (14 ounces) we can try to resuscitate.  If the baby is smaller than this, we don't have supplies that are small enough to help the baby survive

 Thank you for this- I know we can read all the books/posts we want but each hospital has its own policy and it's good to hear this. I hadn't thought about issues with the size of supplies, it makes a lot of sense.  


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11-07-2012 at 9:27 AM
TMWarren85
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 As others have mentioned, around 24 weeks there is a 50% survival rate, once you get to 28 weeks there is closer to 90% but yes- you still need to bake. And to clarify, survival doesn't always mean completely healthy, there may be some significant health issues to battle along the way. But there is a better chance of sustaining life after 24 weeks- My sister went into pre-term labor at 32 weeks, they gave her steroids to help her DS's lungs develop faster, but they ended up being able to stop labor and induced at 39 weeks. There was never a point where they considered letting her deliver at 32 weeks because the survival rate was high, they did everything in their power to stop labor and were able to.


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11-07-2012 at 9:37 AM
eroplane
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I did IVF so I know my dates are exact. I went in with ctx at 23w1d and the NICU doctors told me "viability" was 24 weeks. And they have a level 3 NICU. My babies came unexpectedly at 23w3d. The nurses delivered my son and a NICU doctor delivered my daughter. C-sections are preferred for preemies because they are so delicate and to avoid IVH from a vaginal delivery. I didn't have a chance to make it to OR. Both of my babies went to NICU intubated and developed bilateral level 3 and 4 IVH's. Their chances for "survival" were < 10% and IF they survived their probability for severe disabilities was > 90%. If it hadn't been so unexpected, at shift change, and my babies hadn't been large for their gestation, the doctors wouldn't have tried to resecitate them. 

I'm not saying this to scare anyone, I'm just saying that every situation is different. If IVF isn't in the equation, how can due dates be 100% accurate. 1 day in the womb = 3 days in NICU.  I just don't believe the stories about 20-22 weekers surviving. You see stories like that everywhere but I take it with a grain of salt. Unless there was assisted reproduction involved, there is no way to exactly pinpoint date of conception and gestational age  US is a guess  Even with IVF you could have a "late" implanter. 

Short version: 24 weeks at most hospitals that have a high level NICU.  


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11-07-2012 at 9:39 AM
eroplane
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nola78:
Lariah14:

bdutton0005:
The smallest chance now is at 20 weeks with it being about 4-5% that bay will live. 24 weeks is when they start giving the best chances though. Also from everything I've seen girls are more likely to survive before 24 weeks then boys, they "fight" more.

Boys areborn with less developed lungs, so the chance of survival is lower- they don't "fight" less. That's pretty insulting.  

My son was born at 21 weeks.  Survival at 21 weeks is 0%.   Your whole "fight" comment is pretty distasteful.  

Agreed.  


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11-07-2012 at 10:18 AM
markhamgur...
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SIL is a registered nurse and has told us 24 weeks, so I'm going by what she says :)

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11-07-2012 at 11:56 AM
WinterBens...
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In New Brunswick Canada, our viability date is 26 weeks. 

 
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