Perinatology.  2016 Dec;27(4):195-204. 10.14734/PN.2016.27.4.195.

Obstetrical Management of Late Preterm Pregnancy

Affiliations
  • 1Division of Maternal-fetal Medicine, Department of Obstetrics and Gynecology, Cheil General Hospital & Women's Healthcare Center, DanKook University College of Medicine, Seoul, Korea. sabi0515@hanmail.net

Abstract

The neonatal risks of late preterm (34 0/7-36 6/7 weeks of gestation) births are well established. Late preterm birth results from spontaneous, indicated, and sometime elective indications. Prediction and prevention of preterm birth is currently largely aimed at identifying women at high risk such as those with previous preterm birth, and targeting intervention at this group. Both cervical length assessment and fibronectin testing permit some modification of the likelihood of preterm birth in this group. Progesterone treatment for the prevention of preterm birth is currently being researched widely, and appears a potentially promising strategy. The burden of prematurity can be decreased if elective late preterm delivery is eliminated. However, there are a number of maternal, fetal, and placental complications in which a late preterm delivery is warranted. The timing of delivery in such cases must balance the maternal and newborn risks of late preterm delivery with the risks of further continuation of pregnancy. Decisions regarding timing of delivery must be individualized. The following is a review of obstetric decision-making for late preterm pregnancies.

Keyword

Fetal lung maturation; Late preterm birth; Prematurity

MeSH Terms

Female
Fibronectins
Humans
Infant, Newborn
Parturition
Pregnancy*
Premature Birth
Progesterone
Fibronectins
Progesterone

Cited by  2 articles

Visualization of unstructured personal narratives of perterm birth using text network analysis
Jeung-Im Kim
Korean J Women Health Nurs. 2020;26(3):205-212.    doi: 10.4069/kjwhn.2020.08.08.

Risk Factors Associated with Hypothermia Immediately after Birth among Preterm Infants
Jaewoo An, Bo Kyeong Jin, Heui Seung Jo, Hye-Rim Kim, Kee Hyun Cho, Kyu Hyung Lee
Perinatology. 2018;29(1):20-26.    doi: 10.14734/PN.2018.29.01.20.


Reference

1. Green NS, Damus K, Simpson JL, Iams J, Reece EA, Hobel CJ, et al. Research agenda for preterm birth: recommendations from the March of Dimes. Am J Obstet Gynecol. 2005; 193:626–635.
Article
2. Raju TN. Epidemiology of late preterm (near-term) births. Clin Perinatol. 2006; 33:751–763.
Article
3. 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; 118:323–333.
Article
4. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 560: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2013; 121:908–910.
5. Laughon SK, Reddy UM, Sun L, Zhang J. Precursors for late preterm birth in singleton gestations. Obstet Gynecol. 2010; 116:1047–1055.
Article
6. Reddy UM, Ko CW, Raju TN, Willinger M. Delivery indications at late-preterm gestations and infant mortality rates in the United States. Pediatrics. 2009; 124:234–240.
Article
7. Engle WA, Tomashek KM, Wallman C. “Late preterm” infants: a population at risk. Pediatrics. 2007; 120:1390–1401.
8. Holland MG, Refuerzo JS, Ramin SM, Saade GR, Blackwell SC. Late preterm birth: how often is it avoidable? Am J Obstet Gynecol. 2009; 201:404.e1–404.e4.
Article
9. Gyamfi-Bannerman C, Fuchs K, Young O, Hoffman M. Non-spontaneous late preterm birth: etiology and outcomes. Am J Obstet Gynecol. 2011; 205:456.e1–456.e6.
Article
10. Simmons LE, Rubens CE, Darmstadt GL, Gravett MG. Preventing preterm birth and neonatal mortality: exploring the epidemiology, causes, and interventions. Semin Perinatol. 2010; 34:408–415.
Article
11. Zakar T, Hertelendy F. Progesterone withdrawal: key to parturition. Am J Obstet Gynecol. 2007; 196:289–296.
Article
12. Romero R, Espinoza J, Kusanovic JP, Gotsch F, Hassan S, Erez O, et al. The preterm parturition syndrome. BJOG. 2006; 113:Suppl 3. 17–42.
Article
13. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet. 2008; 371:75–84.
Article
14. Belfort MA. Placenta accreta. Am J Obstet Gynecol. 2010; 203:430–439.
Article
15. Robinson BK, Grobman WA. Effectiveness of timing strategies for delivery of individuals with placenta previa and accreta. Obstet Gynecol. 2010; 116:835–842.
Article
16. Chauhan SP, Magann EF, Wiggs CD, Barrilleaux PS, Martin JN Jr. Pregnancy after classic cesarean delivery. Obstet Gynecol. 2002; 100:946–950.
Article
17. Resnik R, Creasy RK. Intrauterine growth restriction. In : Creasy RK, Resnik R, Iams JD, editors. Maternal fetal medicine: principles and practice. 6th ed. Philadelphia: Saunders/Elsevier;2009. p. 635–650.
18. Boers KE, Vijgen SM, Bijlenga D, van der Post JA, Bekedam DJ, Kwee A, et al. Induction versus expectant monitoring for intrauterine growth restriction at term: randomised equivalence trial (DIGITAT). BMJ. 2010; 341:c7087.
Article
19. Chauhan SP, Scardo JA, Hayes E, Abuhamad AZ, Berghella V. Twins: prevalence, problems and preterm births. Am J Obstet Gynecol. 2010; 203:305–315.
Article
20. Stock S, Norman J. Preterm and term labour in multiple pregnancies. Semin Fetal Neonatal Med. 2010; 15:336–341.
Article
21. Dodd JM, Deussen AR, Grivell RM, Crowther CA. Elective birth at 37 weeks gestation for women with an uncomplicated twin pregnancy. Cochrane Database Syst Rev. 2014; (2):CD003582.
Article
22. Barigye O, Pasquini L, Galea P, Chambers H, Chappell L, Fisk NM. High risk of unexpected late fetal death in monochorionic twins despite intensive ultrasound surveillance: a cohort study. PLoS Med. 2005; 2:e172.
Article
23. Smith NA, Wilkins-Haug L, Santolaya-Forgas J, Acker D, Economy KE, Benson CB, et al. Contemporary management of monochorionic diamniotic twins: outcomes and delivery recommendations revisited. Am J Obstet Gynecol. 2010; 203:133.e1–133.e6.
Article
24. Zhang J, Troendle J, Meikle S, Klebanoff MA, Rayburn WF. Isolated oligohydramnios is not associated with adverse perinatal outcomes. BJOG. 2004; 111:220–225.
Article
25. Ek S, Andersson A, Johansson A, Kublicas M. Oligohydramnios in uncomplicated pregnancies beyond 40 completed weeks. Fetal Diagn Ther. 2005; 20:182–185.
Article
26. Melamed N, Pardo J, Milstein R, Chen R, Hod M, Yogev Y. Perinatal outcome in pregnancies complicated by isolated oligohydramnios diagnosed before 37 weeks of gestation. Am J Obstet Gynecol. 2011; 205:241.e1–241.e6.
Article
27. Koopmans CM, Bijlenga D, Groen H, Vijgen SM, Aarnoudse JG, Bekedam DJ, et al. Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks' gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet. 2009; 374:979–988.
Article
28. Habli M, Levine RJ, Qian C, Sibai B. Neonatal outcomes in pregnancies with preeclampsia or gestational hypertension and in normotensive pregnancies that delivered at 35,36, or 37 weeks of gestation. Am J Obstet Gynecol. 2007; 197:406.e1–406.e7.
29. Barton JR, Barton LA, Istwan NB, Desch CN, Rhea DJ, Stanziano GJ, et al. Elective delivery at 34 to 36 weeks' gestation and its impact on neonatal outcomes in women with stable mild gestational hypertension. Am J Obstet Gynecol. 2011; 204:44.e1–44.e5.
30. Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. JAMA. 2003; 290:199–206.
Article
31. Caritis S, Sibai B, Hauth J, Lindheimer MD, Klebanoff M, Thom E, et al. Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal Fetal Medicine Units. N Engl J Med. 1998; 338:701–705.
32. Sibai BM, Lindheimer M, Hauth J, Caritis S, VanDorsten P, Klebanoff M, et al. Risk factors for preeclampsia, abruptio placentae, and adverse neonatal outcomes among women with chronic hypertension. National Institute of Child Health and Human Development Network of Maternal Fetal Medicine Units. N Engl J Med. 1998; 339:667–671.
33. ACOG Committee on Practice Bulletins. ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. Obstet Gynecol. 2005; 105:675–685.
34. Robert MF, Neff RK, Hubbell JP, Taeusch HW, Avery ME. Association between maternal diabetes and the respiratory distress syndrome in the newborn. N Engl J Med. 1976; 294:357–360.
Article
35. Committee on Practice Bulletins—Obstetrics. Practice Bulletin No. 137: Gestational Diabetes Mellitus. Obstet Gynecol. 2013; 122:406–416.
36. Kjos SL, Henry OA, Montoro M, Buchanan TA, Mestman JH. Insulin-requiring diabetes in pregnancy: a randomized trial of active induction of labor and expectant management. Am J Obstet Gynecol. 1993; 169:611–615.
Article
37. Lurie S, Insler V, Hagay ZJ. Induction of labor at 38 to 39 weeks of gestation reduces the incidence of shoulder dystocia in gestational diabetic patients class A2. Am J Perinatol. 1996; 13:293–296.
Article
38. Harger JH, Hsing AW, Tuomala RE, Gibbs RS, Mead PB, Eschenbach DA, et al. Risk factors for preterm premature rupture of fetal membranes: a multicentre case-control study. Am J Obstet Gynecol. 1990; 163:130–137.
39. ACOG Committee on Practice Bulletins. American College of Obstetricians and Gynecologist. ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologist. Number 43, May 2003. Management of preterm labo. Obstet Gynecol. 2003; 101:1039–1047.
40. ACOG Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 80: premature rupture of membranes. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol. 2007; 109:1007–1019.
41. Kayem G, Bernier-Dupreelle A, Goffinet F, Cabrol D, Haddad B. Active versus expectant management for preterm prelabor rupture of membranes at 34-36 weeks completed gestation: comparison of maternal and neonatal outcomes. Acta Obstet Gynecol Scand. 2010; 89:776–781.
42. Naef RW, Allbert JR, Ross EL, Weber BM, Martin RW, Morrison JC. Premature rupture of membranes at 34 to 37 weeks gestation: aggressive versus conservative management. Am J Obstet Gynecol. 1998; 178:126–130.
Article
43. Mercer BM, Crocker LG, Boe NM, Sibai BM. Induction versus expectant management in premature rupture of the membranes with mature amniotic fluid at 32 to 36 weeks: a randomized trial. Am J Obstet Gynecol. 1993; 169:775–782.
Article
44. Royal College of Obstetricians and Gynaecologists. Preterm prelabour rupture of membranes. Green-top Guideline 44. London: RCOG;2010.
45. To MS, Alfirevic Z, Heath VC, Cicero S, Cacho AM, Williamson PR, et al. Cervical cerclage for prevention of preterm delivery in women with short cervix: randomised controlled trial. Lancet. 2004; 363:1849–1853.
46. Berghella V, Rafael TJ, Szychowski JM, Rust AO, Owen J. Cerclage for short cervix on ultrasonography in women with singleton gestations and previous preterm birth. Obstet Gynecol. 2011; 117:663–671.
Article
47. Berghella V, Mackeen AD. Cervical length screening with ultrasound-indicated cerclage compared with history-indicated cerclage for prevention of preterm birth: a meta-analysis. Obstet Gynecol. 2011; 118:148–155.
48. Royal College of Obstetricians and Gynaecologists. Cervical cerclage. Green-top guideline 60. London: RCOG;2011.
49. Norman JE. Preterm labour. Cervical function and prematurity. Best Pract Res Clin Obstet Gynaecol. 2007; 21:791–806.
50. Meis PJ, Klebanoff M, Thom E, Dombrowski MP, Sibai B, Moawad AH, et al. Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate. N Engl J Med. 2003; 348:2379–2385.
Article
51. da Fonseca EB, Bittar RE, Carvalho MH, Zugaib M. Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk: a randomized placebo-controlled double-blind study. Am J Obstet Gynecol. 2003; 188:419–424.
Article
52. Fonseca EB, Celik E, Parra M, Singh M, Nicolaides KH. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med. 2008; 357:462–469.
Article
53. Royal College of Obstetricians and Gynaecologists. Tocolysis for women in preterm labour. Green-top Guideline 1b. London: RCOG;2011.
54. Roberts D, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2006; (3):CD004454.
Article
55. American College of Obstetricians and Gynecologists. ACOG committee opinion no. 561: Nonmedically indicated early-term deliveries. Obstet Gynecol. 2013; 121:911–915.
56. Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita AT, Reddy UM, Saade GR, Rouse DJ, et al. NICHD Maternal-Fetal Medicine Units Network. Antenatal Betamethasone for Women at Risk for Late Preterm Delivery. N Engl J Med. 2016; 374:1311–1320.
Article
57. Committee Opinion No.677: Antenatal Corticosteroid Therapy for Fetal Maturation. Obstet Gynecol. 2016; 128:e187–e194.
58. Bates E, Rouse DJ, Mann ML, Chapman V, Carlo WA, Tita AT. Neonatal outcomes after demonstrated fetal lung maturity before 39 weeks of gestation. Obstet Gynecol. 2010; 116:1288–1295.
Article
Full Text Links
  • PN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr