Cesarean delivery for fetal malformations.
We reviewed existing data on fetal abnormalities to provide guidelines to determine which conditions have an improved neonatal outcome by cesarean delivery. We used Medline database to search for English language papers on a variety of fetal conditions that could influence the mode of delivery. We reviewed these sources with particular attention to how the mode of delivery influenced neonatal outcome. Conflicting data exist regarding optimal mode of delivery for many fetal conditions. Cesarean delivery may improve neonatal outcome for fetuses with isolated meningomyelocele, hydrocephalus with concomitant macrocephaly, anterior wall defects with extracorporeal liver, sacrococcygeal teratomas, hydrops, and alloimmune thrombocytopenia with low platelet count at term. Hydrocephalus without macrocephaly, anterior wall defects without an extracorporeal liver, ovarian cysts, skeletal dysplasias, fetuses whose mothers have immune thrombocytopenic puer-pura and fetuses with alloimmune thrombocytopenia with acceptable platelet counts may safely be delivered vaginally.
Kuller
J A
JA
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
Katz
V L
VL
Wells
S R
SR
Wright
L N
LN
McMahon
M J
MJ
D002585:Cesarean Section; D000013:Congenital Abnormalities; D005260:Female; D005315:Fetal Diseases; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010048:Ovarian Cysts; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D013724:Teratoma; D013921:Thrombocytopenia