Delivery at Term: When, How, and Why

Kate F Walker; Jim G Thornton

doi:10.1016/j.clp.2018.01.004

Delivery at Term: When, How, and Why

Clin Perinatol. 2018 Jun;45(2):199-211. doi: 10.1016/j.clp.2018.01.004. Epub 2018 Feb 19.

Authors

Kate F Walker¹, Jim G Thornton²

Affiliations

¹ Division of Child Health, Obstetrics, and Gynaecology, Maternity Department, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK. Electronic address: kate.walker@nottingham.ac.uk.
² Division of Child Health, Obstetrics, and Gynaecology, Maternity Department, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK.

PMID: 29747883
DOI: 10.1016/j.clp.2018.01.004

Abstract

There is growing evidence from randomized trials that induction of labor at or near term does not increase cesarean delivery; observational data show that the optimal gestation for spontaneous delivery for the baby is 39 weeks. Elective cesarean at these gestations is also sometimes considered, but evaluating the associated risks is complex. For the baby, although cesarean obviates the risks of labor, it carries a risk of respiratory problems, which may be severe. For the mother, cesarean is more dangerous than vaginal and emergency cesarean is more dangerous than elective. The authors consider the evidence base for near-term induction of labor and cesarean for a range of scenarios.

Keywords: Antepartum stillbirth; Cesarean delivery; Induction of labor; Term.

Publication types

Review

MeSH terms

Cesarean Section / trends
Clinical Decision-Making*
Delivery, Obstetric / methods*
Elective Surgical Procedures / trends
Female
Gestational Age
Humans
Infant, Newborn
Labor, Induced*
Male
Pregnancy
Risk Assessment
Stillbirth
Term Birth*
Time Factors