Journal of clinical gynecology and obstetrics最新文献

{"title":"Fetal Heart Rate as an Indirect Indicator of Treatment Response in Fetal Hyperthyroidism Secondary to Transplacental Passage of Maternal Thyrotropin Receptor Antibodies","authors":"A. Juusela, M. Nazir, Zankhana Patel Batra, Kristina Torrence, M. Gimovsky","doi":"10.14740/jcgo564","DOIUrl":"https://doi.org/10.14740/jcgo564","url":null,"abstract":"Maternal hyperthyroidism is prevalent in 0.2-0.4% of pregnancies. Graves’ disease accounts for 85% of these cases. Approximately 1-5% of neonates born to these mothers develop hyperthyroidism. Transplacental passage of thyrotropin receptor antibodies (TRAbs) are considered to be the likely cause of transient fetal and neonatal hyperthyroidism. An 18-year-old G1P0 with a history of Graves’ disease treated by radioactive ablation presented with persistent fetal tachycardia at 23 weeks gestational age. TRAb was elevated and fetal hyperthyroidism secondary to transplacental crossing of maternal TRAb was suspected. There was no evidence of overt fetal hyperthyroidism or goiter on ultrasound examination. Oral methimazole was initiated and the fetal tachycardia resolved. Upon decrease of the methimazole dosage, the fetal tachycardia returned. Methimazole dosing was again increased and stabilized at a higher dose and the fetal tachycardia remained resolved. At birth at 40 weeks gestation, the neonate was tachycardic with elevated TRAb. She was initiated on methimazole. At 1 month of life, the methimazole dose was halved. At 2 months of life, all medication was held. On further testing, the thyroid function test remained normal. In our patient who did not display evidence of fetal hyperthyroidism on ultrasound examination, as there were no abnormal fetal markers on ultrasound to evaluate treatment response, fetal heart rate on non-stress testing was successfully used as an indirect indicator of fetal thyroid status and guided appropriate titration of methimazole. J Clin Gynecol Obstet. 2019;8(3):91-96 doi: https://doi.org/10.14740/jcgo564","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46690308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Patients With Ectopic Pregnancies","authors":"S. Gencdal, H. Aydoğmuş, N. Gencdal, Emre Destegul, E. Ekmekci","doi":"10.14740/JCGO.V0I0.559","DOIUrl":"https://doi.org/10.14740/JCGO.V0I0.559","url":null,"abstract":"Background: The aim of this study was to evaluate hematologic parameters in ectopic pregnancy. Methods: This retrospective study was conducted at Izmir Katip Celebi University Ataturk Education and Research Hospital between January 2016 and June 2017. The medical records of 97 patients hospitalised for ectopic pregnancy (EP) were summarised. The control group consisted of 112 women at 6 - 8 weeks, healthy, intrauterine gestations as confirmed by ultrasound (positive fetal heart rates). Hematologic parameters including white blood cells, hemoglobin and platelet counts, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) were compared. Results: In total, 209 patients were included in the study: 112 with healthy pregnancies and 97 with EPs. There was no statistically significant difference between the groups regarding mean age, gravidity, parity, number of abortions, body mass index, history for previous cesarean deliveries, and previous EPs. The MPV level was lower in the EP group than in the control group. In addition, the mean NLR was higher in the EP group than in the controls. Conclusions: Considering the sensitivity and specificity, overall, the NLR and MPV has moderate diagnostic potential in patients with ectopic pregnancies. J Clin Gynecol Obstet. 2019;8(3):81-84 doi: https://doi.org/10.14740/jcgo559","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":"8 1","pages":"81-84"},"PeriodicalIF":0.0,"publicationDate":"2019-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43336431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Pelvic Stabilizing Exercises Effective for Postpartum Pelvic Girdle Pain? A Literature Review","authors":"A. Sakamoto, K. Gamada","doi":"10.14740/JCGO.V8I2.552","DOIUrl":"https://doi.org/10.14740/JCGO.V8I2.552","url":null,"abstract":"The effectiveness of exercises to prevent or relieve postpartum pelvic girdle pain (PGP) has been investigated for decades. Although multiple treatment options are available, evidence supporting specific forms of intervention for PGP remains limited. Thus, the effectiveness of exercises and treatments for persistent postpartum PGP has not yet been established. The aim of this literature review was to clarify the effectiveness of exercises based on a review of randomized controlled trials including postpartum women with persistent PGP. We performed a broad search for eligible studies published before May 1, 2018 using the following electronic databases; PubMed, Medline, Pedro, Sage Journal, Google Scholar and the Cochrane Library. Comprehensive combinations of key words were utilized for these searches. Data were evaluated using a review process. The initial online search identified 184 potential studies and six of these studies met the specified criteria. All studies investigated the interventional effects of pelvic stabilizing exercises by assessing pain intensity, physical examination and disability questionnaires. In terms of effectiveness, a significant positive impact on pelvic pain intensity was reported as a result of stabilizing exercise programs for postpartum PGP. There were no adverse events reported in any of these studies. This review demonstrates the paucity of methodologically rigorous research to help healthcare practitioners make reliable decisions regarding the effectiveness of physical exercises for postpartum PGP. An individually tailored program with stabilizing exercises involving all relevant muscles delivered under the guidance of a therapist achieved high patient compliance and was shown to be effective for PGP. J Clin Gynecol Obstet. 2019;8(2):33-38 doi: https://doi.org/10.14740/jcgo552","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":"8 1","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2019-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48114253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grey Platelet Syndrome and Pregnancy: A Case Report and Literature Review","authors":"Francisco Ibarguengoitia-Ochoa, C. M. Sepúlveda-Rivera, Sergio Emmanuel Santoyo-Rosas, Diego Arturo Gonzalez-Vazquez, Jessica Aidee Mora-Galvan, Samuel Vargas-Trujillo","doi":"10.14740/JCGO.V8I2.555","DOIUrl":"https://doi.org/10.14740/JCGO.V8I2.555","url":null,"abstract":"Grey platelet syndrome is an uncommon hereditary platelet disorder, and is characterized by thrombocytopenia and platelet dysfunction with a specific absence of alpha-granules. Electronic microscopy is a quick test that can confirm the diagnosis. We present perinatal results of a patient with diagnosed grey platelet syndrome. We reviewed the case of a patient with grey platelet syndrome at Instituto Nacional de Perinatologia. She is 26 years old, with 21 weeks’ gestation. It is noted in initial laboratories a platelet amount of 64,000/mm 3 , and grey platelet syndrome is suspected, so peripheral blood smear is carried out which showed pale platelets, and electronic microscopy was performed to confirm the disorder, which showed the absence of platelet alpha-granules. A female newborn was delivered at 38.4 week of gestation by abdominal cesarean section, weighing 2,588 g, with platelet count at birth of 119,000/mm 3 . There is no general consensus of treatment in patients with grey platelet syndrome, and management must be multi-disciplinary between obstetrics, hematology and anesthesiology services. J Clin Gynecol Obstet. 2019;8(2):54-56 doi: https://doi.org/10.14740/jcgo555","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46211560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Presence of Nuchal Cord Does Not Hinder the Normal Progression of Labor","authors":"K. Imai","doi":"10.14740/JCGO.V8I2.549","DOIUrl":"https://doi.org/10.14740/JCGO.V8I2.549","url":null,"abstract":"Background: Nuchal cord is a common occurrence at birth, and its relation to some perinatal outcomes has been reported. The objective of this study was to investigate whether the presence of nuchal cord affects the normal progression of labor. Methods: We retrospectively examined women who delivered their babies at our clinic. The inclusion criteria were ≥ 37 weeks of gestation, cephalic presentation and a singleton pregnancy. The rates of induction/augmentation of labor, cesarean section/vacuum extraction and prolonged labor and the durations of the first and second stages of labor were compared between women with and without a nuchal cord, separately among nulliparous and multiparous women. Results: We enrolled 2,277 nulliparous and 2,548 multiparous women. A single nuchal cord was found in 559 (24.5%) nulliparous and 616 (24.2%) multiparous women. Multiple nuchal cords were found in 99 (4.3%) nulliparous and 104 (4.1%) multiparous women. Among nulliparous women, the use of vacuum extraction was higher in women with multiple nuchal cords; no such difference was observed among multiparous women. The rate of induction/augmentation of labor was similar between women with and without a nuchal cord in both nulliparous and multiparous women. Among nulliparous women, the median duration of the first stage of labor was 558, 635 and 550 min (P = 0.211), and that of the second stage of labor was 55, 59 and 60 min (P = 0.183), with no nuchal cord, a single nuchal cord and multiple nuchal cords, respectively. Among multiparous women, the corresponding values were 260, 270 and 256 min (P = 0.313) for the first and 13, 13 and 12 min (P = 0.616) for the second stage. The rate of prolonged labor was similar between nulliparous and multiparous women, regardless of the nuchal cord state. Conclusion: A nuchal cord is not associated with labor induction, nor does it hinder the normal progression of labor. J Clin Gynecol Obstet. 2019;8(2):48-53 doi: https://doi.org/10.14740/jcgo549","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":"8 1","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2019-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67223485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Hemorrhage: Use of Bakri Balloon During Cesarean Delivery, a Case Report and Review","authors":"L. Pillarisetty, T. Thai, M. Mannem, S. Bandaru","doi":"10.14740/JCGO.V8I2.556","DOIUrl":"https://doi.org/10.14740/JCGO.V8I2.556","url":null,"abstract":"The American College of Obstetricians and Gynecologists recently revised the definition of postpartum hemorrhage (PPH) to a cumulative blood loss of ≥ 1,000 mL (or) blood loss associated with signs or symptoms of hypovolemia within 24 h of the birth process. PPH is one leading cause of maternal mortality across the world. Prompt identification of the risk factors is proven to be helpful in earlier detection of PPH and is critical in preventing severe complications and related maternal morbidity and mortality. In this case report, we discuss a 29-year-old patient who had PPH at the time of cesarean delivery. This was effectively controlled by placement of an intraoperative Bakri balloon. The purpose of this review was to discuss and describe the indications and technique of Bakri balloon at the time of cesarean delivery complicated by PPH. Bakri balloon tamponade is usually indicated as a second-line treatment for severe PPH only when initial trials of bimanual compression of the uterus and uterotonic drugs fail to control bleeding. This appears to have minimal adverse effects on subsequent menstrual and reproductive function when intrauterine balloon tamponade is used for the management of severe PPH. Early use of intrauterine balloon tamponade is a way of effectively limiting ongoing uterine blood loss while initiating other measures, and can be readily implemented by providers with minimal training. Bakri balloon tamponade can be a life-saving intervention at the time of PPH and can reduce the need for a hysterectomy. J Clin Gynecol Obstet. 2019;8(2):57-61 doi: https://doi.org/10.14740/jcgo556","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41713326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Mid-Urethral Tape Insertion","authors":"P. Bachkangi, M. Salman","doi":"10.14740/JCGO.V0I0.544","DOIUrl":"https://doi.org/10.14740/JCGO.V0I0.544","url":null,"abstract":"Background: Urinary stress incontinence is a health condition affecting millions of women globally with an incidence reaching 35%. The initial management is usually of conservative nature in the form of pelvic floor muscle training. If this fails then surgical management is offered. There are different methods of managing urinary stress incontinence like mid-urethral tape (MUT) insertion, colposuspension or the use of urethral bulking agents. In our unit, MUT insertion has been the conventional method of surgical management. Methods: The data were obtained from retrospective auditing of our practice in our Trust that was conducted on three different phases over 4 years (2011 to 2015). The source of information was the database and clinical notes. Results: A total of 221 patients underwent MUT insertion. Thirty-five procedures were performed by urologists and 185 by gynecologists. Twenty-three surgeries were performed by gynecologic trainees under senior supervision. All the MUT insertions performed by urologists were performed by consultants. Fifty patients (22.6%) experienced urinary retention, 18 had to use clean intermittent catheterization (CISC) (8%), and 41 patients (13%) developed symptoms of over-active bladder. There have been four bladder perforations (1.8%) all associated with tension-free vaginal tape (TVT) procedures and two cases of tape erosions (1%). Four patients (5%) complained of groin pain post-operatively; all of them had undergone tension-free obturator tape (TVT-O) procedure. There have been no buttonhole injuries, pelvic hematomata, or bleeding complications. In addition to that there have been no post-operative infections. Conclusions: Our complication rates have been concomitant with those described in literature. A surgical database proves helpful not only in auditing surgical effectiveness but also in comparing the surgical managements between different surgeons and departments. J Clin Gynecol Obstet. 2019;8(2):44-47 doi: https://doi.org/10.14740/jcgo544","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42104934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tendency Prediction for Atonic Bleeding Following a Problem-Free Pregnancy","authors":"A. Yanaihara, S. Hatakeyama, Shirei Ougi, A. Hirano, T. Yanaihara","doi":"10.14740/JCGO.V0I0.540","DOIUrl":"https://doi.org/10.14740/JCGO.V0I0.540","url":null,"abstract":"Background: The incidence of postpartum hemorrhage (PPH) has increased globally; however, the reasons for this are largely unknown. PPH is potentially fatal and atonic PPH can occur even in low-risk pregnancies. In this study, we aimed to identify the causes of atonic bleeding following a problem-free pregnancy. Methods: One thousand, four hundred sixty-six patients with problem-free pregnancies who experienced total bleeding 2 h after vaginal delivery were divided into two groups based on the amount of blood loss: control group (n = 1,325), with a blood loss of < 800 mL and study group (n = 141) with a blood loss of ≥ 800 mL. Several factors that may correlate with atonic bleeding were divided into three groups: maternal demographic (MD) factors, intrapartum factors, and fatal factors. Comparisons were made between the control group and study group regarding these factors. A multivariate analysis and receiver operating characteristic (ROC) analysis were performed to identify the independent risk factors for atonic bleeding. The continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were also calculated. Results: The independent factors being statistically significant that predicted over 800 mL of atonic bleeding were in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancies (adjusted odd ratio (OR): 3.63; 95% confidence interval (CI): 2.46 - 5.36; P < 0.001), new-born weight (adjusted OR: 1.0016; 95% CI: 1.0011 - 1.0022; P < 0.001), and the cases of instrumental labor (IL) (adjusted OR: 2.48; 95% CI: 1.64 - 3.77; P < 0.001). ROCs for the final model (area under the curve (AUC): 0.765; 95% CI: 0.724 - 0.806), fatal model (AUC: 0.675; 95% CI: 0.627 - 0.723), intrapartum model (AUC: 0.654; 95% CI: 0.612 - 0.696) and MD model (AUC: 0.615; 95% CI: 0.575 - 0.656) were constructed. The NRI and IDI were 0.733 (95% CI: 0.565 - 0.901; P < 0.0001) and 0.073 (95% CI: 0.051 - 0.90; P < 0.0001) in the fatal model and final model, 0.057 (95% CI: -0.117 - 0.230; P = 0.288) and 0.015 (95% CI: -0.004 - 0.034; P = 0.521) in the MD model, and -0.146 (95% CI: -0.319 - 0.027; P = 0.098) and -0.003 (95% CI: -0.021 - 0.014; P = 0.700) in the intrapartum model. Conclusions: We concluded that IVF/ICSI pregnancies, new-born weight, and IL were independent factors contributing to atonic bleeding. The coincidence of these three factors significantly predicts the likelihood of atonic bleeding. J Clin Gynecol Obstet. 2019;8(2):39-43 doi: https://doi.org/10.14740/jcgo540","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43789655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction of Labor and Risk for Emergency Cesarean Section in Women at Term Pregnancy","authors":"Gomathy Ethiraj, Aditi C. Ramachandra, Sandhya Rajan","doi":"10.14740/JCGO.V8I1.433","DOIUrl":"https://doi.org/10.14740/JCGO.V8I1.433","url":null,"abstract":"Background: Induction of labor has become one of the most common interventions in obstetrics, and because of this we have the increasing number of Cesarean sections. Identifying these risk factors which increase the risk of Cesarean section has become important so that we can induce patients putting them in lower risk of Cesarean section. Cesarean sections should be audited using the obstetrical concepts and parameters for induction of labor. Methods: A prospective case-control study has been conducted among pregnant women between 37 - 42 weeks of gestation, who were recruited from the labor ward for a period of 1 year. All women enrolled for the study were clinically examined to assess for Bishop’s score, obstetric scan and cardiotocography (CTG). Induction was done using tab misoprostol 50 µg 6th hourly for a maximum of four doses in 24 h and augmented with oxytocin if required. In our tertiary hospital in Kolar district of Karnataka we decided to conduct a study with a sample size of 178 patients. We assessed the risk factors in term pregnancies and their delivery outcome following induction. Baseline demographic details along with pregnancy risk factors were taken into account. Induction agent as well as induction to delivery interval with those that underwent Cesarean section was also taken into account. Pregnancy outcome was determined. Results: This study concluded that significant risk factor for Cesarean was primigravida with fetal distress due to oligohydramnios, compared to other risk factors such as preeclampsia, gestational hypertension, post-dated pregnancy and gestational diabetes mellitus. Bishops score prior to induction was < 6. Out of these women 43 underwent Cesarean after induction in view of fetal distress for non reassuring nonstress test (NST). Primigravida had a risk of 4.4 times for Cesarean after induction, and absence of oligohydramnios was a protective factor in the study with odds ratio of 0.2. Conclusions: Induction of labor at term has reduced the number of Cesarean sections in our study with a single risk factor. J Clin Gynecol Obstet. 2019;8(1):17-20 doi: https://doi.org/10.14740/jcgo433w","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46968407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing of an Elective Repeat Cesarean Delivery at Term: Addressing the Controversy","authors":"M. Ramadan, A. Abdulrahim, S. Itani, Mohamad Hourani, F. Mirza","doi":"10.14740/JCGO.V8I1.526","DOIUrl":"https://doi.org/10.14740/JCGO.V8I1.526","url":null,"abstract":"Background: Although most professional societies recommend scheduling elective repeat cesarean deliveries (ERCDs) at 39 weeks, some care providers have started to practice scheduling at earlier timing for various reasons. The objective of our study was to compare the outcomes of scheduling ERCDs at 3 different weeks at term. Methods: In a prospective, observational cohort study conducted over a 2-year period, 339 parturients were scheduled for ERCD at 37, 38 or 39 weeks. In an intention-to-treat approach, we are reporting the rates of delivery before schedule, maternal and neonatal morbidity corresponding to each of these three decisions. Results: A total of 5.3% of deliveries scheduled at 37 weeks were performed before schedule, compared to 16.1% and 46.7% of those scheduled at 38 and 39 weeks, respectively (P < 0.0001). Likewise, delivery outside working hours demonstrated a trend that increased with gestation but was only statistically significant between 38 versus 39 weeks. As expected, a significant improvement was identified for neonatal intensive care unit (NICU) admissions and respiratory morbidity between 37 versus 39 weeks but was minimal between 38 versus 39 weeks. There was no difference in maternal outcome parameters among the three categories. Conclusions: Individualizing patients, according to their risk of spontaneous labor, added obstetric complications if progressed in pregnancy and maternity resources should be integrated in the decision of scheduling ERCD. Scheduling at 38 weeks might curb unplanned delivery rate at the expense of a marginal, though non-significant, increase of neonatal respiratory morbidity. J Clin Gynecol Obstet. 2019;8(1):1-8 doi: https://doi.org/10.14740/jcgo526","PeriodicalId":87296,"journal":{"name":"Journal of clinical gynecology and obstetrics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43421610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}