The pregnancy at risk for delivery at the threshold of viability.

PURPOSE OF REVIEW: To examine updated recommendations for obstetrical interventions that may improve neonatal outcomes in extremely preterm births.

RECENT FINDINGS: Several recent studies of antenatal steroids at the threshold of viability have demonstrated benefits in both survival and survival without major morbidity. This has led to revised recommendations from the American College of Obstetricians and Gynecologist regarding the timing of antenatal steroids in these extremely preterm fetuses.

SUMMARY: These recent developments have important implications for clinical care in patients at risk for extremely preterm birth based on a model of best practices and shared decision-making.