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Does gestational age have an effect on admission to neonatal units in babies born by elective caesarean section at term (37 weeks and above) gestation?
  1. S Nishtala,
  2. C Balachandar,
  3. L Woodward
  1. Manor Hospital, Walsall, UK

Abstract

Aims To determine if scheduling an elective caesarean section (LSCS) at 39/40 gestation is beneficial to neonate in terms of admission to neonatal unit (NNU), respiratory support required and length of stay in the unit.

Methods Data of all babies born at term (≥37/40) gestation by LSCS and admitted to NNU from 1 January 2002 to 31 January 2008 in a district general hospital was assessed retrospectively.

Comparison of outcome in babies born at 39 weeks was made with those born between 37−38+6 weeks.

Results During the 6 year period, 141 babies of term gestation born by Caesarean section were admitted to neonatal unit, of which 32% were elective LSCS.

Among these admissions born by elective LSCS, 53.3% required respiratory support, of which 75% were born at <39 weeks gestation.

The only support required by the babies born at ≥39 weeks was, oxygen at levels of <30%, for a maximum duration of 12 h. 83% of babies required it for <4 h. 83% of these babies were diagnosed as transitional tachypnoea of the newborn (TTN). Average length of stay was 6 days.

In comparison, babies born at <39 weeks, 37% required oxygen, 27% required CPAP, 11% required intubation and ventilation. Oxygen requirements were 30–70%, with 25% babies requiring oxygen for >48 h. 58% were diagnosed as TTN and 41% with surfactant deficient lung disease. Average length of stay was 8 days.

Conclusion Scheduling elective LSCS at ≥39/40 gestation is beneficial to babies in terms of reduced admission to NNU and respiratory support.

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