[Obstetrics]

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Neonatology

Background:

• Recent guidelines address lung maturation for preterm deliveries after 37 weeks gestation.
• Concerns persist regarding the high number needed to treat and potential neurological effects.
• Established practices for vaginal birth after cesarean and uterine closure are being re-evaluated.

Purpose of the Study:

• To review current evidence on interventions for preterm delivery and maternal-fetal medicine.
• To evaluate the benefits and risks of antenatal corticosteroids for lung maturation.
• To discuss advancements in achieving vaginal birth after cesarean and surgical techniques.

Main Methods:

• Systematic review of recent studies and guidelines.
• Analysis of data on short-term benefits and long-term risks of interventions.
• Evaluation of ultrasound techniques for assessing uterine scar integrity.
• Review of surgical methods for uterine closure during cesarean delivery.
• Discussion of aspirin's role in pre-eclampsia prevention.

Main Results:

• Antenatal corticosteroids show short-term benefits for lung maturation but require a high number of cases to prevent complications, with potential neurological risks.
• Ultrasound measurement of the lower uterine segment is beneficial for assessing risk during attempted vaginal birth after cesarean.
• Optimal uterine closure techniques during cesarean delivery are under investigation.
• Aspirin remains a key consideration for pre-eclampsia risk reduction.

Conclusions:

• Careful consideration of benefits versus risks is needed for lung maturation interventions in late preterm infants.
• Ultrasound assessment and refined surgical techniques can improve safety for vaginal birth after cesarean.
• Aspirin continues to be a valuable tool in managing pre-eclampsia risk.