CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(12): 1212-1216
DOI: 10.1055/a-0669-1480
GebFra Science
Statement/Stellungnahme
Georg Thieme Verlag KG Stuttgart · New York

Statement by the OEGGG with Review of the Literature on the Mode of Delivery of Premature Infants at the Limit of Viability

Artikel in mehreren Sprachen: English | deutsch
Thorsten Fischer
1   Universitätsklinik für Frauenheilkunde und Geburtshilfe der Paracelsus Medizinischen Universität Salzburg, Salzburg, Austria
,
Manfred Mörtl
2   Frauenklinik des Klinikums Klagenfurt, Klagenfurt am Wörthersee, Austria
,
Philipp Reif
3   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
,
Herbert Kiss
4   Medizinische Universität Wien, Universitätsklinik für Frauenheilkunde, Vienna, Austria
,
Uwe Lang
3   Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Austria
,
for the Austrian Society for Gynaecology and Obstetrics (OEGGG) › Institutsangaben
Weitere Informationen

Publikationsverlauf

received 16. Mai 2018
revised 02. August 2018

accepted 03. August 2018

Publikationsdatum:
14. Dezember 2018 (online)

Abstract

In 2017, the Austrian Society for Paediatric and Adolescent Medicine (ÖGKJ) published a guideline on the primary care of premature infants at the limit of viability. In this guideline, it is recommended that a Caesarean section be preferred as mode of delivery with regard to an early preterm birth (22 + 0 – 24 + 6 weeks of pregnancy) due to an allegedly lower perinatal risk of cerebral haemorrhage. In contrast to this, the Austrian Society for Gynaecology and Obstetrics (OEGGG) considers there to be no clinical and scientific basis for this recommendation and the mode of delivery in the case of early preterm birth must be adapted to the individual maternal and foetal clinical situation. The international data available from the generally retrospective investigations show heterogeneous results regarding the mode of delivery. The prospective and randomised data in this regard are insufficient. A Cochrane analysis does not show any advantage in favour of a Caesarean delivery. The German-language guidelines (AWMF and Switzerland) make analogous recommendations for adapting the mode of delivery with regard to an early preterm birth individually to the respective clinical situation. In the case of an early preterm birth and a singleton in cephalic presentation, the OEGGG therefore recommends individual management of the delivery which takes the maternal and foetal clinical situation into account and also includes vaginal delivery as a mode of delivery in the clinical decision process.