И, конечно, совсем разные вещи, когда роды начинаются в 37 недель спонтанно, и, когда делают пкс или индуцируют родыhttp://www.acog.org/acog_districts/dist_notice.cfm?recno=1&bulletin=3629из пресс-релиза американского общества акушеров-гинеколгов (ACOG):
New York, New York, November 30, 2010 - In an effort to reduce the number of late preterm births, the March of Dimes New York Chapter announced today it will partner with the New York State Department of Health (NYSDOH) and the New York State Chapter of the American Congress of Obstetricians and Gynecologists (ACOG District II) to help educate health care providers and the public on the importance of the last weeks of pregnancy and the risk of early deliveries. A healthy, full term-pregnancy lasts 39-40 weeks, yet there has been a rise in births scheduled prior to that time through inductions and C-sections that are not medically necessary - a practice once thought to be safe.
Research shows that scheduling births, even a few weeks too early, may result in babies having feeding, breathing and learning problems. They are also more likely to die of Sudden Infant Death Syndrome (SIDS).Along with the California Maternal Quality Care Collaborative and the California Department of Health, the March of Dimes collaborated to develop a tool kit to guide and support obstetrical providers, clinical staff, hospitals, and health care organizations
to develop a successful quality improvement program to eliminate elective deliveries less than 39 weeks and help more babies be born healthy.Ob-Gyn Dr. Cynthia Chazotte, Co-Chair of ACOG District II's Safe Motherhood Initiative and Professor and Vice Chair of Ob/Gyn at the Montefiore Medical Center/Albert Einstein College of Medicine said, "
Cesarean delivery on maternal request should not be performed before gestational age of 39 weeks has been accurately determined unless there is documentation of lung maturity. Furthermore, potential risks of cesarean delivery on maternal request include a longer hospital stay and greater complications in subsequent pregnancies, including uterine rupture and hemorrhage from abnormal implantation of the placenta."
ну и зрелость легких они определяют:
узи для оценки гестационного возраста плода + анализ околоплодных вод на соотношение лицетина-сфингомиелина
однако как пишут тут:
Recent studies suggest that testing for fetal lung maturity at more advanced gestational ages is neither reliable nor cost effective.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505159/потому все же ACOG в протоколах 2010 года рекомендует не индуцировать роды и не делать пкс ранее 39 недели без медицинских показаний.
ну и:
Preterm birth (before 37 completed weeks gestation,) is a serious health crisis that costs the United States more than $26 billion annually. It is the leading cause of newborn death, and babies who survive an early birth often face the risk of serious and sometimes lifelong health problems such as breathing problems, mental retardation, jaundice, developmental delays, vision loss and cerebral palsy. Babies born just a few weeks too soon (34-36 weeks gestation, also known as late preterm birth) have higher rates of death and disability than full-term babies. Even infants born at 37-38 weeks have an increased risk for problems compared to infants born at 39 weeks.
http://www.marchofdimes.com/aboutus/49267_61147.asp
Тема: Роды после кесарева 17 (Прочитано 143054 раз)