Document Detail


Neuromaturation of multiples.
MedLine Citation:
PMID:  12234745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Etiology of preterm birth and degree of maturation are the primary determinants of a preterm infant's survival and complications. Multiple gestation increases the likelihood of preterm birth but its influence on rate of maturation or complications of prematurity has been controversial, primarily because of confounding variables (e.g. race, aetiology of preterm delivery, degree of prematurity and pregnancy complications). Very low birthweight preterm multiples have virtually the same rates of neonatal mortality, complications and neuromaturation as preterm singletons of the same gestational age. There is no advantage of delivering twins or higher order multiples before 30 weeks gestation, unless a fetus decompensates in utero. Survival improves for near term intermediate-size preterm multiples while intrauterine growth decelerates and placental and fetal neuromaturation accelerate. These data and the high fetal death rate at term support delivery of multiples as soon as there is fetal lung maturity, and consideration of elective delivery of twins at 35-38 weeks gestation and triplets at 33-35 weeks gestation.
Authors:
Marilee C Allen; Pamela K Donohue
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in neonatology : SN     Volume:  7     ISSN:  1084-2756     ISO Abbreviation:  Semin Neonatol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-09-17     Completed Date:  2002-12-27     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9606001     Medline TA:  Semin Neonatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  211-21     Citation Subset:  IM    
Affiliation:
The Eudowood Division of Neonatology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287-3200, USA. mcallen@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Decision Making
Delivery, Obstetric*
Embryonic and Fetal Development*
Female
Fetal Growth Retardation / physiopathology
Humans
Infant Mortality
Infant, Newborn
Infant, Premature / physiology*
Nervous System / embryology*
Pregnancy
Pregnancy, Multiple*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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