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Just thought this might be of interest for some of
the listers.
'Assigned Week of Delivery' More Practical Than
Obstetric Due Date
WESTPORT, CT (Reuters Health) Nov 30 - An
"assigned week of delivery," determined through clinician skill and
training, should replace the arbitrarily calculated due date, physicians
in Eugene, Oregon, recommend.
In the December issue of Obstetrics and Gynecology, Dr.
Vern L. Katz and colleagues from Sacred Heart Medical Center note that
physicians use dating to see how far a patient has progressed. In
contrast, women use it to set expectations about a definite point in time
when they will deliver, and many feel anxious if the date is exceeded. "In
our culture, being overdue is not a desirable quality," the authors point
out.
They add that the due date, never empirically established, "was derived
by a 17th century botanist, Booerhave, who read in the Bible that
pregnancy should last 10 lunar months."
The team proposes that patients be given an assigned week of delivery
at 32 weeks' gestation, individualized for each clinical situation. For
most pregnancies, the assigned week of delivery might be between 39.5 and
40.5 weeks' gestation, while a patient with twins would likely be given a
week corresponding to 38 weeks' gestation and a primipara might receive a
prediction of 40 to 41 weeks' gestation.
The result would be that approximately 95% of all births would take
place during the assigned week, Dr. Katz and his associates predict,
improving both obstetric practice and patient satisfaction.
"The problem is that the term 'due date' has caused tremendous anxiety
and tension over the last 3 decades because to patients, the concept of
being 'overdue' has such a terrible connotation," Dr. Katz told Reuters
Health.
"Plus, we clinicians literally spend more time explaining why a person
isn't really due on their due date than we spend on testing for AIDS,
neural tube defects, and high blood sugars, and explaining what labor is
like," he added.
He noted that this model has worked well for him and his co-workers. "I
think that the paradigm will catch on, and that physicians and nurse
practitioners will work harder and harder to get rid of the 'due date'
concept," Dr. Katz predicted. "However, some may prefer to offer a 10-day
window or a 5-day window, depending on the kinds of patients they see in
their practices."
Obstet Gynecol 2001;98:1127-1129.
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