Download PDF
Am J Perinatol 2012; 29(01): 27-34
DOI: 10.1055/s-0031-1285830
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Scheduled Deliveries: Avoiding Iatrogenic Prematurity

Nancy Chescheir
1   Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
,
M. Kathryn Menard
1   Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
› Author Affiliations
Further Information

Publication History

06 June 2011

06 June 2011

Publication Date:
22 August 2011 (online)

    Permissions and Reprints

Abstract

The balance of maternal, fetal, and neonatal risks of continued pregnancy versus iatrogenic delivery must be based on best evidence. Although avoiding elective deliveries prior to 39 weeks is well established to improve neonatal outcomes, several “soft” conditions are commonly considered to require delivery prior to 39 weeks. Review of existing literature suggests that with some of these conditions, delivery can be safely delayed until later in pregnancy or even allowed to proceed without intervention. Late preterm and early term deliveries contribute substantially to neonatal morbidity and health care costs and should be considered only if the risks of continuing the pregnancy exceed the neonatal risks related to early birth. In this article, we review some the common clinical scenarios that may result in scheduled early term or late preterm births, with a focus on practice strategies for improving maternal and neonatal outcomes.

Keywords

elective delivery - induction of labor - late preterm birth
 

  • References

  • 1 American College of Obstetricians and Gynecologists Practice Bulletin No. ACOG. 107: Induction of Labor. Obstet Gynecol 2009; 114: 386-397
    CrossrefPubMedGoogle Scholar
  • 2 Landon MB, Hauth JC, Leveno KJ , et al; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med 2004; 351: 2581-2589
    CrossrefPubMedGoogle Scholar
  • 3 Clark SL, Miller DD, Belfort MA, Dildy GA, Frye DK, Meyers JA. Neonatal and maternal outcomes associated with elective term delivery. Am J Obstet Gynecol 2009; 200: 156; e1-e4
    PubMedGoogle Scholar
  • 4 Oshiro BT, Henry E, Wilson J, Branch DW, Varner MW ; Women and Newborn Clinical Integration Program. Decreasing elective deliveries before 39 weeks of gestation in an integrated health care system. Obstet Gynecol 2009; 113: 804-811
    CrossrefPubMedGoogle Scholar
  • 5 Reddy UM, Bettegowda VR, Dias T, Yamada-Kushnir T, Ko C-W, Willinger M. Term pregnancy: a period of heterogeneous risk for infant mortality. Obstet Gynecol 2011; 117: 1279-1287
    CrossrefPubMedGoogle Scholar
  • 6 Moster D, Wilcox AJ, Vollset SE, Markestad T, Lie RT. Cerebral palsy among term and postterm births. JAMA 2010; 304: 976-982
    CrossrefPubMedGoogle Scholar
  • 7 Reddy UM, Ko C-W, Raju TN, Willinger M. Delivery indications at late-preterm gestations and infant mortality rates in the United States. Pediatrics 2009; 124: 234-240
    CrossrefPubMedGoogle Scholar
  • 8 Donovan EF, Lannon C, Bailit J, Rose B, Iams JD, Byczkowski T Ohio Perinatal Quality Collaborative Writing Committee A statewide initiative to reduce inappropriate scheduled births at 36(0/7)-38(6/7) weeks' gestation. Am J Obstet Gynecol 2010; 202: 243; e1-e8
    PubMedGoogle Scholar
  • 9 Laughon SK, Reddy UM, Sun L, Zhang J. Precursors for late preterm birth in singleton gestations. Obstet Gynecol 2010; 116: 1047-1055
    CrossrefPubMedGoogle Scholar
  • 10 American College of Obstetricians and Gynecologists. ACOG Practice bulletin no. 115: Vaginal birth after previous cesarean delivery. Obstet Gynecol 2010; 116 (2 Pt 1) 450-463
    CrossrefPubMedGoogle Scholar
  • 11 Bethune M, Permezel M. The relationship between gestational age and the incidence of classical caesarean section. Aust N Z J Obstet Gynaecol 1997; 37: 153-155
    CrossrefPubMedGoogle Scholar
  • 12 de Costa C. Vaginal birth after classical Caesarean section. Aust N Z J Obstet Gynaecol 2005; 45: 182-186
    CrossrefPubMedGoogle Scholar
  • 13 Al-Zirqi I, Stray-Pedersen B, Forsén L, Vangen S. Uterine rupture after previous caesarean section. BJOG 2010; 117: 809-820
    CrossrefPubMedGoogle Scholar
  • 14 Chibber R, El-Saleh E, Al Fadhli R, Al Jassar W, Al Harmi J. Uterine rupture and subsequent pregnancy outcome—how safe is it? A 25-year study. J Matern Fetal Neonatal Med 2010; 23: 421-424
    CrossrefPubMedGoogle Scholar
  • 15 Hofmeyr GJ, Say L, Gülmezoglu AM. WHO systematic review of maternal mortality and morbidity: the prevalence of uterine rupture. BJOG 2005; 112: 1221-1228
    CrossrefPubMedGoogle Scholar
  • 16 Lim AC, Kwee A, Bruinse HW. Pregnancy after uterine rupture: a report of 5 cases and a review of the literature. Obstet Gynecol Surv 2005; 60: 613-617
    CrossrefPubMedGoogle Scholar
  • 17 O'Connor RA, Gaughan B. Pregnancy following simple repair of the ruptured gravid uterus. Br J Obstet Gynaecol 1989; 96: 942-944
    PubMedGoogle Scholar
  • 18 Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG 2004; 111: 220-225
    PubMedGoogle Scholar
  • 19 Garmel SH, Chelmow D, Sha SJ, Roan JT, D'Alton ME. Oligohydramnios and the appropriately grown fetus. Am J Perinatol 1997; 14: 359-363
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Conway DL, Groth S, Adkins WB, Langer O. Management of isolated oligohydramnios in the term pregnancy: a randomized clinical trial. Am J Obstet Gynecol 2000; 182: s21
    PubMedGoogle Scholar
  • 21 Magann EF, Kinsella MJ, Chauhan SP, McNamara MF, Gehring BW, Morrison JC. Does an amniotic fluid index of </=5 cm necessitate delivery in high-risk pregnancies? A case-control study. Am J Obstet Gynecol 1999; 180 (6 Pt 1) 1354-1359
    CrossrefPubMedGoogle Scholar
  • 22 Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD. Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: a meta-analysis. Am J Obstet Gynecol 1999; 181: 1473-1478
    CrossrefPubMedGoogle Scholar
  • 23 Manzanares S, Carrillo MP, González-Perán E, Puertas A, Montoya F. Isolated oligohydramnios in term pregnancy as an indication for induction of labor. J Matern Fetal Neonatal Med 2007; 20: 221-224
    CrossrefPubMedGoogle Scholar
  • 24 Casey BM, McIntire DD, Bloom SL , et al. Pregnancy outcomes after antepartum diagnosis of oligohydramnios at or beyond 34 weeks' gestation. Am J Obstet Gynecol 2000; 182: 909-912
    CrossrefPubMedGoogle Scholar
  • 25 Nabhan AF, Abdelmoula YA. Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome. Cochrane Database Syst Rev 2008; (3) CD006593
    PubMedGoogle Scholar
  • 26 Alberry M, Soothill P. Management of fetal growth restriction. Arch Dis Child Fetal Neonatal Ed 2007; 92: F62-F67
    CrossrefPubMedGoogle Scholar
  • 27 Ananth CV, Vintzileos AM. Distinguishing pathological from constitutional small for gestational age births in population-based studies. Early Hum Dev 2009; 85: 653-658
    CrossrefPubMedGoogle Scholar
  • 28 Torrance HL, Bloemen MCT, Mulder EJH , et al. Predictors of outcome at 2 years of age after early intrauterine growth restriction. Ultrasound Obstet Gynecol 2010; 36: 171-177
    PubMedGoogle Scholar
  • 29 Kinzler WL, Vintzileos AM. Fetal growth restriction: a modern approach. Curr Opin Obstet Gynecol 2008; 20: 125-131
    CrossrefPubMedGoogle Scholar
  • 30 Turan S, Miller J, Baschat AA. Integrated testing and management in fetal growth restriction. Semin Perinatol 2008; 32: 194-200
    CrossrefPubMedGoogle Scholar
  • 31 Witkop CT, Neale D, Wilson LM, Bass EB, Nicholson WK. Active compared with expectant delivery management in women with gestational diabetes: a systematic review. Obstet Gynecol 2009; 113: 206-217
    CrossrefPubMedGoogle Scholar
  • 32 Practice Bulletin No ACOG. 30. Gestational diabetes. Obstet Gynecol 2001; 98: 525-538
    PubMedGoogle Scholar
  • 33 American Diabetes Association. Gestational diabetes mellitus. Diabetes Care 2004; 27 (Suppl 1) S88-S90
    CrossrefPubMedGoogle Scholar
  • 34 Boulvain M, Stan CM, Irion O. Elective delivery in diabetic pregnant women. Cochrane Database Syst Rev 2001; (2) CD001997
    PubMedGoogle Scholar
  • 35 Piper JM, Xenakis EM, Langer O. Delayed appearance of pulmonary maturation markers is associated with poor glucose control in diabetic pregnancies. J Matern Fetal Med 1998; 7: 148-153
    CrossrefPubMedGoogle Scholar
  • 36 Moore TR. A comparison of amniotic fluid fetal pulmonary phospholipids in normal and diabetic pregnancy. Am J Obstet Gynecol 2002; 186: 641-650
    CrossrefPubMedGoogle Scholar
  • 37 Piper JM, Langer O. Does maternal diabetes delay fetal pulmonary maturity?. Am J Obstet Gynecol 1993; 168 (3 Pt 1) 783-786
    PubMedGoogle Scholar
  • 38 American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 97: Fetal lung maturity. Obstet Gynecol 2008; 112: 717-726
    CrossrefPubMedGoogle Scholar
  • 39 National high blood pressure education working group on high blood pressure in pregnancy. Am J Obstet Gynecol 2000; 183: S1-S22
    CrossrefPubMedGoogle Scholar
  • 40 Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol 2003; 102: 181-192
    CrossrefPubMedGoogle Scholar
  • 41 Koopmans CM, Bijlenga D, Groen H , et al; HYPITAT study group Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet 2009; 374: 979-988
    CrossrefPubMedGoogle Scholar
  • 42 Bates E, Rouse DJ, Mann ML, Chapman V, Carlo WA, Tita AT. Neonatal outcomes after demonstrated fetal lung maturity before 39 weeks of gestation. Obstet Gynecol 2010; 116: 1288-1295
    CrossrefPubMedGoogle Scholar
  • 43 Kamath BD, Marcotte MP, Defranco EA. Neonatal morbidity after documented fetal lung maturity in late preterm and early term infants. Am J Obstet Gynecol 2011; 204: 518.e1-518.e8
    PubMedGoogle Scholar
  • 44 Gronowski AM. Contemporary issues in fetal lung maturity testing. Clin Biochem 2011; 44: 458-459
    CrossrefPubMedGoogle Scholar