Abstract
Objective To assess whether standard fetal biometric parameters can be used to predict difficult
intubations in periviable neonates undergoing resuscitation.
Study Design This is a retrospective case–control study of periviable neonates delivered at 23
to 256/7 weeks at an academic hospital during a 5-year period in whom intubation was attempted.
Standard fetal biometric measurements were included if they were taken within 7 days
of delivery. Primary outcome was intubation in one attempt and was compared with more
than one attempt. Data were also collected for fetal gestational age at delivery,
neonatal birth weight, estimated fetal weight, head circumference, biparietal diameter,
and abdominal circumference. Parametric and nonparametric statistical tests used p < 0.05 as significant.
Results In total, 93 neonates met the inclusion criteria. The mean estimated fetal weight
was 675 g (standard deviation [SD] ± 140), and the mean neonatal birth weight was
706 g (SD ± 151). The median interval between fetal ultrasound and delivery was 3
days (range: 0–7 days). A total of 45 neonates (48.3%) required more than one intubation
attempt. The median number of intubation attempts was 1 (range: 1–10). There was no
association between intubation difficulty and fetal abdominal circumference, biparietal
diameter, head circumference, gestational age, estimated fetal weight, and neonatal
birth weight (all p > 0.05).
Conclusion Standard biometry in periviable neonates does not predict intubation difficulty.
Keywords
periviable - intubation - preterm birth - biometry
