Cargando…

Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability

In 2017, the Austrian Society for Paediatric and Adolescent Medicine (ÖGKJ) published a guideline on the primary care of premature infants at the limit of viability. In this guideline, it is recommended that a Caesarean section be preferred as mode of delivery with regard to an early preterm birth (...

Descripción completa

Detalles Bibliográficos
Autores principales: Fischer, Thorsten, Mörtl, Manfred, Reif, Philipp, Kiss, Herbert, Lang, Uwe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294639/
https://www.ncbi.nlm.nih.gov/pubmed/30655647
http://dx.doi.org/10.1055/a-0669-1480
_version_ 1783380768380157952
author Fischer, Thorsten
Mörtl, Manfred
Reif, Philipp
Kiss, Herbert
Lang, Uwe
author_facet Fischer, Thorsten
Mörtl, Manfred
Reif, Philipp
Kiss, Herbert
Lang, Uwe
author_sort Fischer, Thorsten
collection PubMed
description In 2017, the Austrian Society for Paediatric and Adolescent Medicine (ÖGKJ) published a guideline on the primary care of premature infants at the limit of viability. In this guideline, it is recommended that a Caesarean section be preferred as mode of delivery with regard to an early preterm birth (22 + 0 – 24 + 6 weeks of pregnancy) due to an allegedly lower perinatal risk of cerebral haemorrhage. In contrast to this, the Austrian Society for Gynaecology and Obstetrics (OEGGG) considers there to be no clinical and scientific basis for this recommendation and the mode of delivery in the case of early preterm birth must be adapted to the individual maternal and foetal clinical situation. The international data available from the generally retrospective investigations show heterogeneous results regarding the mode of delivery. The prospective and randomised data in this regard are insufficient. A Cochrane analysis does not show any advantage in favour of a Caesarean delivery. The German-language guidelines (AWMF and Switzerland) make analogous recommendations for adapting the mode of delivery with regard to an early preterm birth individually to the respective clinical situation. In the case of an early preterm birth and a singleton in cephalic presentation, the OEGGG therefore recommends individual management of the delivery which takes the maternal and foetal clinical situation into account and also includes vaginal delivery as a mode of delivery in the clinical decision process.
format Online
Article
Text
id pubmed-6294639
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Georg Thieme Verlag KG
record_format MEDLINE/PubMed
spelling pubmed-62946392019-01-15 Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability Fischer, Thorsten Mörtl, Manfred Reif, Philipp Kiss, Herbert Lang, Uwe Geburtshilfe Frauenheilkd In 2017, the Austrian Society for Paediatric and Adolescent Medicine (ÖGKJ) published a guideline on the primary care of premature infants at the limit of viability. In this guideline, it is recommended that a Caesarean section be preferred as mode of delivery with regard to an early preterm birth (22 + 0 – 24 + 6 weeks of pregnancy) due to an allegedly lower perinatal risk of cerebral haemorrhage. In contrast to this, the Austrian Society for Gynaecology and Obstetrics (OEGGG) considers there to be no clinical and scientific basis for this recommendation and the mode of delivery in the case of early preterm birth must be adapted to the individual maternal and foetal clinical situation. The international data available from the generally retrospective investigations show heterogeneous results regarding the mode of delivery. The prospective and randomised data in this regard are insufficient. A Cochrane analysis does not show any advantage in favour of a Caesarean delivery. The German-language guidelines (AWMF and Switzerland) make analogous recommendations for adapting the mode of delivery with regard to an early preterm birth individually to the respective clinical situation. In the case of an early preterm birth and a singleton in cephalic presentation, the OEGGG therefore recommends individual management of the delivery which takes the maternal and foetal clinical situation into account and also includes vaginal delivery as a mode of delivery in the clinical decision process. Georg Thieme Verlag KG 2018-12 2018-12-14 /pmc/articles/PMC6294639/ /pubmed/30655647 http://dx.doi.org/10.1055/a-0669-1480 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Fischer, Thorsten
Mörtl, Manfred
Reif, Philipp
Kiss, Herbert
Lang, Uwe
Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability
title Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability
title_full Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability
title_fullStr Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability
title_full_unstemmed Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability
title_short Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability
title_sort statement by the oeggg with review of the literature on the mode of delivery of premature infants at the limit of viability
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294639/
https://www.ncbi.nlm.nih.gov/pubmed/30655647
http://dx.doi.org/10.1055/a-0669-1480
work_keys_str_mv AT fischerthorsten statementbytheoegggwithreviewoftheliteratureonthemodeofdeliveryofprematureinfantsatthelimitofviability
AT mortlmanfred statementbytheoegggwithreviewoftheliteratureonthemodeofdeliveryofprematureinfantsatthelimitofviability
AT reifphilipp statementbytheoegggwithreviewoftheliteratureonthemodeofdeliveryofprematureinfantsatthelimitofviability
AT kissherbert statementbytheoegggwithreviewoftheliteratureonthemodeofdeliveryofprematureinfantsatthelimitofviability
AT languwe statementbytheoegggwithreviewoftheliteratureonthemodeofdeliveryofprematureinfantsatthelimitofviability
AT statementbytheoegggwithreviewoftheliteratureonthemodeofdeliveryofprematureinfantsatthelimitofviability