Optimal delivery for preterm breech fetuses: is there any consensus?
Hong Kong Med J
; 19(3): 251-7, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23603780
ABSTRACT
The optimal route for delivery of preterm breech-presenting fetuses remains a clinical dilemma. Available data from the literature are largely based on retrospective cohort studies, and randomised controlled trials are considered impossible to conduct. Consistently however, large population-based surveys have shown that planned caesarean sections for these fetuses were associated with better neonatal outcomes compared with those following vaginal delivery. Nevertheless, the increased surgical risks for the mother having caesarean delivery of an early preterm breech fetus must be balanced with the probable neonatal survival benefits. Planned caesarean section should probably be limited to gestations with at least a fair chance of independent neonatal survival, where vaginal delivery is not imminent, and in the absence of other maternal risk factors. Vaginal delivery would probably include those fetuses that are of marginal viability, and that additional protection from abdominal delivery was unlikely to be beneficial to neonatal outcome.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Apresentação Pélvica
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Parto Obstétrico
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Nascimento Prematuro
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
Hong Kong Med J
Assunto da revista:
MEDICINA
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Hong Kong