| The morbidity of the 34- to 35-week gestation: should we reexamine the paradigm? | |
| | |
MedLine Citation:
|
PMID: 15017476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Algorithms for the management of preterm labor avoid the use of tocolysis beyond 34 weeks' gestation, based in large part on low respiratory morbidity found at this gestational age. We sought to delineate the morbidities, not just respiratory, of this age group in a modern neonatal intensive care unit setting. We prospectively looked at hospital resource use and general morbidity in a consecutive 2-year cohort of 34-weekers at our hospital. The concurrent consecutive 35-week cohort was used as a control. Data were prospectively collected from obstetricians and bedside records. Compared with 35-weekers, the 34-week group had similar obstetric characteristics. Significant differences were seen in use of oxygen, nasal continuous positive airway pressure, methylxanthines, home apnea monitoring, antibiotics, and phototherapy. The 34-week group took longer to come off intravenous lines and were discharged later. Overall, they used approximately twice the resources of the 35-week group. To stop or not use tocolysis at 34 weeks' gestation based mainly on low respiratory morbidity ignores the significant other morbidities. These findings suggest a reconsideration of the paradigm regarding 34-week gestation as a cutoff point in decision making. |
| | |
Authors:
|
Igor M Gladstone; Vern L Katz |
Related Documents
:
|
21577046 - Successful surgical drainage and aggressive medical therapy in a preterm neonate with b... 16427896 - Right ventricular outflow tract stent as a bridge to surgery in a premature infant with... 22770106 - Effects of antenatal corticosteroids on neonatal outcomes in very-low-birth-weight pret... 19329516 - Neonatal vitamin a supplementation for prevention of mortality and morbidity in infancy... 7225736 - A low volume burn resuscitation regimen: assessment of performance by probit analysis. 2299726 - Penile agenesis: a fatal variation of an uncommon lesion. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: American journal of perinatology Volume: 21 ISSN: 0735-1631 ISO Abbreviation: Am J Perinatol Publication Date: 2004 Jan |
Date Detail:
|
Created Date: 2004-03-12 Completed Date: 2004-06-03 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 8405212 Medline TA: Am J Perinatol Country: United States |
Other Details:
|
Languages: eng Pagination: 9-13 Citation Subset: IM |
Affiliation:
|
Departments of Pediatrics and Obstetrics/Gynecology, Sacred Heart Medical Center, 1200 Hilyard Street #190, Eugene, OR 97401, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Algorithms Cohort Studies Decision Making Female Gestational Age* Humans Infant, Newborn Infant, Newborn, Diseases / epidemiology*, etiology Infant, Premature* Intensive Care Units, Neonatal / statistics & numerical data Male New York City / epidemiology Obstetric Labor, Premature / prevention & control Practice Guidelines as Topic* Pregnancy Pregnancy Outcome Pregnancy Trimester, Third Prenatal Care / standards* Prospective Studies Tocolysis / standards* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The effect of antenatal corticosteroids on fetal growth, survival, and neurodevelopmental outcome in...
Next Document: Contralateral cerebral infarction following vacuum extraction.