Extremely preterm cesarean delivery: a clinical study.
OBJECTIVE
To describe indications for cesarean section for extremely preterm delivery, peri- and postoperative complications and perinatal outcome.


METHODS
A case-referent study with clinical follow-up.


METHODS
A tertiary perinatal center.


METHODS
All deliveries at gestational age <28 weeks at Umeå University Hospital in 1997-2003. For preterm cesarean section referents were women with elective first-time term cesarean section.


METHODS
Indications for cesarean section delivery were assessed. Peri- and postoperative complications, asphyxia, and infant survival at discharge were described.


RESULTS
The cesarean section rate was 75%, in one third the operation was considered as difficult. Indications for extremely preterm abdominal delivery were severe disease during pregnancy and delivery complications. Six out of ten cesarean sections were performed on fetal indication. Nonisthmic incision was performed in 20% of cases. No major postoperative complications and few minor postoperative complications were noted. Irrespective of mode of delivery, few of the infants had severe asphyxia.


CONCLUSIONS
In balancing the risks of complications related to the surgical procedure against the purported benefits of the infant, this study adds support to the argument to deliver even extremely preterm infants by cesarean section.
Högberg
U
U
Obstetrics and Gynecology, Umeå University, Umeå, Sweden. ulf.hogberg@obgyn.umu.se
Håkansson
S
S
Serenius
F
F
Holmgren
P A
PA
D000328:Adult; D001238:Asphyxia Neonatorum / Q000453:epidemiology*; D002585:Cesarean Section / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007234:Infant, Premature / Q000254:growth & development*; D018743:Perinatal Care; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery; D011256:Pregnancy Outcome