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. 2021 Jul 1;138(1):e35-e39.
doi: 10.1097/AOG.0000000000004447.

Medically Indicated Late-Preterm and Early-Term Deliveries: ACOG Committee Opinion, Number 831

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Medically Indicated Late-Preterm and Early-Term Deliveries: ACOG Committee Opinion, Number 831

American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice, Society for Maternal-Fetal Medicine. Obstet Gynecol. .

Abstract

The neonatal risks of late-preterm and early-term births are well established, and the potential neonatal complications associated with elective delivery at less than 39 0/7 weeks of gestation are well described. However, there are a number of maternal, fetal, and placental complications in which either a late-preterm or early-term delivery is warranted. The timing of delivery in such cases must balance the maternal and newborn risks of late-preterm and early-term delivery with the risks associated with further continuation of pregnancy. Deferring delivery to the 39th week is not recommended if there is a medical or obstetric indication for earlier delivery. If there is a clear indication for a late-preterm or early-term delivery for either maternal or newborn benefit, then delivery should occur regardless of the results of lung maturity testing. Conversely, if delivery could be delayed safely in the context of an immature lung profile result, then no clear indication for a late-preterm or early-term delivery exists. Also, there remain several conditions for which data to guide delivery timing are not available. Some examples of these conditions include uterine dehiscence or chronic placental abruption. Delivery timing in these circumstances should be individualized and based on the current clinical situation.

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Conflict of interest statement

All ACOG committee members and authors have submitted a conflict of interest disclosure statement related to this published product. Any potential conflicts have been considered and managed in accordance with ACOG’s Conflict of Interest Disclosure Policy. The ACOG policies can be found on acog.org. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. The American College of Obstetricians and Gynecologists has neither solicited nor accepted any commercial involvement in the development of the content of this published product.

References

    1. Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. Eunice Kennedy Shriver NICHD Maternal-Fetal Medicine Units Network. N Engl J Med 2009;360:111–20.
    1. Clark SL, Miller DD, Belfort MA, Dildy GA, Frye DK, Meyers JA. Neonatal and maternal outcomes associated with elective term delivery. Am J Obstet Gynecol 2009; 200:156.e1–4.
    1. Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities. ACOG Committee Opinion No. 765. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;133:e156–63.
    1. Spong CY, Mercer BM, D'alton M, Kilpatrick S, Blackwell S, Saade G. Timing of indicated late-preterm and early- term birth. Obstet Gynecol 2011;118:323–33.
    1. Management of suboptimally dated pregnancies. Committee Opinion No. 688. American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;129:e29–32.

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