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ABSTRACT: Infant survival with ever-decreasing birthweights is attainable with recent advances in maternal-fetal medicine and enhanced neonatal intensive care. We report a gestation complicated by severe chronic hypertension and fetal distress necessitating delivery at 26 1/7 weeks. The growth-retarded newborn weighed 345 g (12 oz) and survived with minimal sequelae despite a protracted and complicated neonatal course.