Vaginal delivery safe for head first births before 32 weeks

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Infants born to mothers attempting to deliver vaginally before the 32nd week of pregnancy are as likely to survive as those delivered by a planned cesarean, provided the fetus is in the head-first position, according to researchers at the National Institutes of Health.

Pregnancy typically lasts about 40 weeks. Infants born before the 37th week of pregnancy are classified as preterm, and those born before the 32nd week of pregnancy are classified as early preterm. Preterm infants are at risk for a number of health problems, including increased risk of infant death, cerebral palsy, developmental delays, infection and vision and hearing problems. According to the Centers for Disease Control and Prevention, 54 percent of all infant deaths in the United States occur among the 2 percent of infants born before the 32nd week of pregnancy.

Some studies have suggested that infants delivered vaginally before 32 weeks are less likely to survive through infancy than those delivered by a planned cesarean delivery and more likely to suffer injury and health effects after passing through the birth canal. Cesarean delivery, especially in the early preterm period, poses risks for the mother, such as hemorrhage, bladder injury, and other complications. Women who undergo cesarean delivery are at risk for rupture of the uterus during labor and other complications in subsequent pregnancies.

Their findings appear online in the American Journal of Obstetrics and Gynecology.