Oversight of elective early term deliveries: avoiding unintended consequences.

The perinatal quality collaborative of North Carolina's 39 weeks project: a quality improvement program to decrease elective deliveries before 39 weeks of gestation.

BACKGROUND Despite long-standing guidelines from the American College of Obstetricians and Gynecologists that call for avoiding elective births prior to 39 weeks of gestation, elective deliveries make up almost one-third of US births occurring in weeks 36-38. Poor outcomes are more likely for infants born electively before 39 weeks than for those born at 39 weeks. The Perinatal Quality Collabor...

Decreasing elective deliveries before 39 weeks of gestation in an integrated health care system.

OBJECTIVE The American College of Obstetricians and Gynecologists has recommended that elective deliveries not be performed before 39 weeks of gestation, to minimize prematurity-related neonatal complications. Because a worrisome number of elective deliveries were occurring before 39 weeks of gestation in our system, we developed and implemented a program to decrease the number of these early t...

A multistate quality improvement program to decrease elective deliveries before 39 weeks of gestation.

OBJECTIVE Nonmedically indicated (elective) deliveries before 39 weeks of gestation result in unnecessary neonatal morbidity. We sought to determine whether implementation of a process improvement program will decrease the rate of elective scheduled singleton early-term deliveries (37 0/7-38 6/7 weeks of gestation) in a group of diverse community and academic hospitals. METHODS Policies and p...

Elective induction: an analysis of economic and health consequences.

OBJECTIVE Our purpose was to assess economic and health consequences of elective induction at term. STUDY DESIGN A decision-tree model incorporating a Markov analysis was used to compare the decision either to electively induce labor at term or expectantly manage the pregnancy until 42 weeks' gestation. Main outcome measures, stratified by parity, cervical ripeness, and gestational age at ind...

Avoiding no man's land Potential unintended consequences of follow-on biologics