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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Late preterm birth: management dilemmas.

Cynthia Gyamfi-Bannerman1

  • 1Division of Maternal-Fetal Medicine, Columbia University Medical Center, 622 West 168th Street, New York, NY 10032, USA. cg2231@columbia.edu

Obstetrics and Gynecology Clinics of North America
|February 29, 2012
PubMed
Summary
This summary is machine-generated.

Eliminating elective late preterm delivery can reduce the burden of prematurity. Clinicians must weigh the risks of iatrogenic prematurity against delivery benefits for maternal or fetal indications.

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Area of Science:

  • Maternal-Fetal Medicine
  • Neonatology
  • Obstetrics

Background:

  • Late preterm birth (34-36 weeks gestation) arises from spontaneous, indicated, or elective reasons.
  • The incidence of late preterm birth has increased, contributing significantly to overall prematurity.
  • Current management guidelines exist but often rely on lower-grade evidence.

Purpose of the Study:

  • To analyze the indications for late preterm delivery.
  • To evaluate the impact of elective late preterm delivery on prematurity burden.
  • To guide clinical decision-making regarding delivery timing in the late preterm period.

Main Methods:

  • Review of existing literature and guidelines.
  • Analysis of indications for spontaneous, indicated, and elective late preterm births.
  • Assessment of evidence grading for current management recommendations.

Main Results:

  • Elective late preterm delivery contributes to the burden of prematurity.
  • Specific maternal or fetal conditions necessitate late preterm delivery.
  • Evidence supporting current guidelines is predominantly Grade B or C.

Conclusions:

  • Eliminating elective late preterm delivery is crucial for reducing prematurity.
  • Clinical decisions for late preterm delivery require careful risk-benefit assessment.
  • Balancing iatrogenic risks with maternal/fetal benefits is essential for intervention.