Ray Chaudhuri Bhatta Smriti, Keriakos Remon
Obstetrics and Gynaecology, Sheffield Teaching Hospitals, Sheffield S10 2SF, UK.
J Pregnancy. 2011;2011:186560. doi: 10.1155/2011/186560. Epub 2011 Jul 24.
Choosing the safest method of delivery and preventing preterm labour are obstetric challenges in reducing the number of preterm births and improving outcomes for mother and baby. Optimal route of delivery for preterm vertex neonates has been a controversial topic in the obstetric and neonatal community for decades and continues to be debated. We reviewed 22 studies, most of which have been published over the last five years with an aim to find answers to the clinical questions relevant to deciding the mode of delivery. Findings suggested that the neonatal outcome does not depend on the mode of delivery. Though Caesarean section rates are increasing for preterm births, it does not prevent neurodisability and cannot be recommended unless there are other obstetric indications to justify it. Therefore, clinical judgement of the obstetrician depending on the individual case still remains important in deciding the mode of delivery.
选择最安全的分娩方式并预防早产是产科在减少早产数量及改善母婴结局方面面临的挑战。数十年来，早产足月儿的最佳分娩途径一直是产科和新生儿学界颇具争议的话题，且仍在讨论中。我们回顾了22项研究，其中大部分是在过去五年发表的，旨在寻找与决定分娩方式相关临床问题的答案。研究结果表明，新生儿结局并不取决于分娩方式。尽管早产的剖宫产率在上升，但它并不能预防神经残疾，除非有其他产科指征作为依据，否则不建议采用剖宫产。因此，产科医生根据具体病例进行的临床判断在决定分娩方式时仍然很重要。
