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November 7, 1977

Diagnosis of Fetal Maturity as Requisite for Elective Obstetrical Delivery

JAMA. 1977;238(19):2060. doi:10.1001/jama.1977.03280200072030

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The neonatal intensive care unit, an integral part of regional planning in maternal and child care, has enhanced the lowering of perinatal mortality to 14.9 per 1,000 live births in 1977. Associated with regional planning is the outcome assessment by audit of risks and benefits of medical care. Maisels et al (p 2036) have audited and identified elective delivery of the fetus as an obstetrical hazard when fetal maturity is not established and verified before delivery.

The use of "elective" delivery by patient request or for hospital service and physician's convenience requires reexamination for its merit. Newer audit outcome not previously identified by widely diversified centers with low local incidence of complication, when combined and examined by regional data, seems unacceptable when iatrogenically caused asphyxia, respiratory distress syndrome, pneumothorax, pneumomediastinum, and large financial costs are reported.

In addition, parenting disorders, failure of normal growth and development, subsequent unexplained death syndromes,