Gestational age and the management of preterm labor in obstetric programs

The gestational age at which obstetric training programs aggressively manage and attempt to salvage preterm vertex fetuses in distress was determined by survey. More than half the programs initiate fetal monitoring and perform cesarean section for certain cases of fetal distress by 26 weeks gestational age. By 28 weeks gestational age, most programs consistently perform a cesarean delivery for a vertex fetus in distress. Management practices in university training programs appear to be more aggressive than those in nonuniversity programs. Not all programs--either within or outside the university--try aggressively to salvage fetuses in distress at 28 weeks gestational age or more, however, despite the excellent chance for survival and normal development.