Obstet Gynecol. 2021 Jul 1;138(1):166-169. doi: 10.1097/AOG.0000000000004448.
The neonatal risks of late-preterm and early-term births are well established, and the potential neonatal complications associated with elective delivery at less than 39 0/7 weeks of gestation are well described. However, there are a number of maternal, fetal, and placental complications in which either a late-preterm or early-term delivery is warranted. The timing of delivery in such cases must balance the maternal and newborn risks of late-preterm and early-term delivery with the risks associated with further continuation of pregnancy. Deferring delivery to the 39th week is not recommended if there is a medical or obstetric indication for earlier delivery. If there is a clear indication for a late-preterm or early-term delivery for either maternal or newborn benefit, then delivery should occur regardless of the results of lung maturity testing. Conversely, if delivery could be delayed safely in the context of an immature lung profile result, then no clear indication for a late-preterm or early-term delivery exists. Also, there remain several conditions for which data to guide delivery timing are not available. Some examples of these conditions include uterine dehiscence or chronic placental abruption. Delivery timing in these circumstances should be individualized and based on the current clinical situation.
晚期早产儿和早期足月儿的新生儿风险已得到充分证实，与妊娠小于39 0/7周时择期分娩相关的潜在新生儿并发症也有详细描述。然而，存在一些母体、胎儿和胎盘并发症，在这些情况下晚期早产或早期足月分娩是必要的。在这种情况下，分娩时机必须在晚期早产和早期足月分娩的母体和新生儿风险与继续妊娠相关的风险之间取得平衡。如果有医学或产科指征需要提前分娩，不建议推迟到第39周分娩。如果有明确指征表明晚期早产或早期足月分娩对母体或新生儿有益，那么无论肺成熟度检测结果如何都应进行分娩。相反，如果在肺成熟度检测结果不成熟的情况下可以安全推迟分娩，那么就不存在晚期早产或早期足月分娩的明确指征。此外，仍有一些情况缺乏指导分娩时机的数据。这些情况的一些例子包括子宫裂开或慢性胎盘早剥。在这些情况下，分娩时机应个体化，并基于当前的临床情况。
