Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
Am J Perinatol. 2012 Jan;29(1):27-34. doi: 10.1055/s-0031-1285830. Epub 2011 Aug 22.
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.
必须基于最佳证据来平衡母婴和新生儿继续妊娠与医源性分娩的风险。虽然避免在 39 周前进行选择性分娩已被证实可以改善新生儿结局，但通常认为有几种“软性”情况需要在 39 周前进行分娩。对现有文献的回顾表明，对于其中一些情况，可以安全地延迟分娩至妊娠后期，甚至可以在不干预的情况下继续妊娠。晚期早产和早期足月分娩会导致新生儿发病率和医疗保健费用大幅增加，只有在继续妊娠的风险超过与早产相关的新生儿风险时才应考虑进行分娩。在本文中，我们回顾了一些可能导致计划中的早期足月或晚期早产的常见临床情况，并重点介绍了改善母婴结局的实践策略。
