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Comparative Study
. 2012 Aug;207(2):117.e1-8.
doi: 10.1016/j.ajog.2012.06.023. Epub 2012 Jun 19.

Neonatal mortality by attempted route of delivery in early preterm birth

Uma M Reddy  1 , Jun Zhang, Liping Sun, Zhen Chen, Tonse N K Raju, S Katherine Laughon
Affiliations
Comparative Study

Neonatal mortality by attempted route of delivery in early preterm birth

Uma M Reddy et al. Am J Obstet Gynecol. 2012 Aug.

Abstract

Objective: We sought to study neonatal outcomes in early preterm births by delivery route.

Study design: Delivery precursors were analyzed in 4352 singleton deliveries, 24 0/7 to 31 6/7 weeks' gestation. In a subset (n = 2906) eligible for a trial of labor, neonatal mortality in attempted vaginal delivery (VD) was compared to planned cesarean delivery stratified by presentation.

Results: Delivery precursors were classified as maternal or fetal conditions (45.7%), preterm premature rupture of membranes (37.7%), and preterm labor (16.6%). For vertex presentation, 79% attempted VD and 84% were successful. There was no difference in neonatal mortality. For breech presentation, at 24 0/7 to 27 6/7 weeks' gestation, 31.7% attempted VD and 27.6% were successful; neonatal mortality was increased (25.2% vs 13.2%, P = .003). At 28 0/7 to 31 6/7 weeks' gestation, 30.5% attempted VD and 17.2% were successful; neonatal mortality was increased (6.0% vs 1.5%, P = .016).

Conclusion: Attempted VD for vertex presentation has a high success rate with no difference in neonatal mortality unlike breech presentation.

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Conflict of interest statement

Disclosure: None of the authors have a conflict of interest

Figures

Figure 1
Figure 1. Flowchart of study cohort
Study cohort description
See this image and copyright information in PMC

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