12/07/2026
Periviability is not a fixed cut-off—it is a changing probability.
At 23+4 weeks, with PPROM, established labour and an estimated fetal weight of 520 g, decisions must be individualised. Survival and long-term disability depend not only on gestational age, but also on infection, fetal condition, birth weight, steroid exposure and NICU capability.
The priority is honest joint counselling by obstetrics and neonatology, antenatal corticosteroids and magnesium sulphate when active neonatal care is planned, PPROM antibiotics when appropriate, and timely delivery if infection or fetal compromise develops.
Every additional day may improve outcome—but prolongation should never come at the cost of maternal safety.
Severe bilateral hydronephrosis at 31 weeks with hydroureters and a distended bladder suggests fetal lower urinary tract obstruction—commonly posterior urethral valves.
Normal amniotic fluid is reassuring, but renal damage may still progress. Serial monitoring, planned delivery at a tertiary centre, and early neonatal urology assessment are essential.
Antenatal fetal SVT with a sustained heart rate around 240 bpm is an emergency because prolonged tachycardia can cause heart failure and hydrops.
Early fetal echocardiography, transplacental antiarrhythmic treatment and close maternal–fetal monitoring can restore rhythm and improve outcomes.
Congenital complete heart block in an anti-Ro–positive pregnancy reflects immune-mediated injury to the fetal conduction system.
A ventricular rate of 55/min requires close surveillance for hydrops and cardiac dysfunction, with planned delivery at a tertiary centre equipped for neonatal pacing.
