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Resultados maternos y neonatales asociados al parto electivo a termino. Neonatal and maternal outcomes associated with elective term delivery
CONCLUSIONES: El parto electivo antes de 39 semanas de gestación se asocia con una importante morbilidad neonatal. La dilatación inicial del cuello uterino es altamente correlacionado con la cesárea entre las mujeres que se someten a inducción. El parto electivo antes de 39 semanas completas de gestación es inapropiado
Texto completo en la web del American Journal of Obstetrics and Gynecology>>
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Objective
To quantify adverse neonatal and maternal outcomes associated with elective term delivery at less than 39 completed weeks of gestation.
Study design
Prospective observational study conducted in 27 hospitals over the course of 3 months in 2007.
Results
Of 17,794 deliveries, 14,955 (84%) occurred at 37 weeks or greater. Of term deliveries, 6562 (44%) were planned, rather than spontaneous. Among the planned deliveries, 4645 (71%) were purely elective; 17.8% of infants delivered electively without medical indication at 37-38 weeks and 8% of those delivered electively at 38-39 weeks required admission to a newborn special care unit for an average of 4.5 days, compared with 4.6% of infants delivered at 39 weeks or beyond (P < .001). Cesarean delivery rate in women undergoing induction of labor was not influenced by gestational age but was highly influenced by initial cervical dilatation and parity, ranging from 0% for parous women induced at 5 cm or greater to 50% for nulliparous women at 0 cm.
Conclusion
Elective delivery before 39 weeks' gestation is associated with significant neonatal morbidity. Initial cervical dilatation is highly correlated with cesarean delivery among women undergoing induction of labor in both nulliparous and parous women. Elective delivery before 39 completed weeks' gestation is inappropriate. Women contemplating elective induction at or beyond 39 weeks' gestation with an unfavorable cervix should be counseled regarding an increased rate of cesarean delivery.
Anterior: El MOMENTO de la CESAREA electiva de repetición a termino y resultados neonatales.Timing of elective repeat cesarean delivery at term and neonatal outcomes.
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