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Re: 41 week Induction From: Efrain Ramirez (eramirezt@coqui.net) Sat Dec 3 13:30:03 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: 41 week Induction" Previous message: Efrain Ramirez: "Re: Error Condition --> split infinitive" In reply to: DoctorJoe@aol.com: "Re: 41 week Induction" Next in thread: art fougner, md: "Re: 41 week Induction" 1: Br J Obstet Gynaecol. 1998 Feb;105(2):169-73. Related Articles, Links Prolonged pregnancy: evaluating gestation-specific risks of fetal and infant mortality. Hilder L, Costeloe K, Thilaganathan B. Department of Epidemiology and Medical Statistics, St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary Westfield College, London. OBJECTIVE: To evaluate gestation-specific risks of stillbirth, neonatal and post-neonatal mortality. DESIGN: Retrospective analysis of 171,527 notified births (1989-1991) and subsequent infant survival at one year, from community child health records. SETTING: Notifications from maternity units in the North East Thames Region, London. MAIN OUTCOME MEASURES: The incidence of births, stillbirths, neonatal and post-neonatal deaths at each gestation after 28 completed weeks. Mortality rates per 1000 total or live births and per 1000 ongoing pregnancies at each gestation were calculated. RESULTS: The rates of stillbirth at term (2.3 per 1000 total births) and post-term (1.9 per 1000 total births) were similar. When calculated per 1000 ongoing pregnancies, the rate of stillbirth increased six-fold from 0.35 per 1000 ongoing pregnancies at 37 weeks to 2.12 per 1000 ongoing pregnancies at 43 weeks of gestation. Neonatal and post-neonatal mortality rates fell significantly with advancing gestation, from 151.4 and 31.7 per 1000 live births at 28 weeks, to reach a nadir at 41 weeks of gestation (0.7 and 1.3 per 1000 live births, respectively), increasing thereafter in prolonged gestation to 1.6 and 2.1 per 1000 live births at 43 weeks of gestation. When calculated per 1000 ongoing pregnancies, the overall risk of pregnancy loss (stillbirth + infant mortality) increased eight-fold from 0.7 per 1000 ongoing pregnancies at 37 weeks to 5.8 per 1000 ongoing pregnancies at 43 weeks of gestation. CONCLUSION: The risks of prolonged gestation on pregnancy are better reflected by calculating fetal and infant losses per 1000 ongoing pregnancies. There is a significant increase in the risk of stillbirth, neonatal and post-neonatal mortality in prolonged pregnancy. This study provides accurate data on gestation-specific risks of pregnancy loss, enabling pregnant women and their carers to judge the appropriateness of obstetric intervention. At Sat, 3 Dec 2005, DoctorJoe@aol.com wrote: > >In a message dated 12/3/05 11:41:58 AM, eramirezt@coqui.net writes: > >> >41 weeks to me is 40 completed weeks - not 40 + 1 day .. >> >> Ooops - 41 completed weeks >> >And speaking of that, does anyone have handy the old graph of gestational age >versus mortality in lots of the text books. It's a "J-curve" with it's nadir >at about 41 1/2 weeks and makes the timing perfectly clear. > >Joe P. -- Ability is what you're capable of doing. Motivation determines what you do. Attitude determines how well you do it. - Lou Holtz ~walt whitman~ Next message: art fougner, md: "Re: 41 week Induction" Previous message: Efrain Ramirez: "Re: Error Condition --> split infinitive" In reply to: DoctorJoe@aol.com: "Re: 41 week Induction" Next in thread: art fougner, md: "Re: 41 week Induction"

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