Article I found about NoT having early deliver for IUGR!!!!!

August 6, 2004

Slight Delay of Delivery May Benefit Infants Who Fail to Thrive in

Utero

By Pincock

LONDON (Reuters Health) Aug 05 - A European study has shown a

possible advantage in slightly delaying delivery of preterm infants

who fail to thrive in utero.

These infants are often delivered early, but the effect of altering

the time of delivery has not been assessed in a randomized trial, the

Growth Restriction Intervention Trial (GRIT) study group writes in

August 7th issue of The Lancet.

They undertook a study in 548 pregnant women in 13 European

countries. The participants had compromised fetuses between weeks 24

and 36, an umbilical-Doppler waveform recorded, and clinical

uncertainty about whether immediate delivery was indicated.

The fetuses were randomly assigned to immediate delivery or delayed

delivery until the obstetrician was no longer uncertain.

The average delay was 4.5 days. " Overall rate of death or severe

disability at 2 years was 55 (19%) of 290 immediate births, and 44

(16%) of 283 delayed births, " Professor Jim Thornton from City

Hospital, Nottingham, UK, and colleagues write. Disability was

defined as a Griffiths development quotient of 70 or less or the

presence of motor or perceptual severe disability.

Most of the difference between the two groups was in disability in

infants younger than 31 weeks at randomization -- which was seen in

14 in the immediate group and 5 delayed deliveries -- the authors

note.

" This is a good news story, " Professor Thornton told Reuters

Health. " This is really very good clinical evidence that...doctors

are delivering bang on the button to minimise mortality. We didn't

know that until now. "

Professor Thornton pointed out that mortality was no higher in the

delayed arm, and there was a trend toward less brain damage. " You get

the benefit without paying a price in terms of mortality, " he said.

His group suggests that the results should discourage doctors from

delivering compromised preterm infants before the point at which

delivery can be delayed no longer.

" This caution applies particularly to pregnancies for which early

delivery is considered before 30 weeks, " they conclude. " In this

situation, we believe that the obstetrician should delay. "

Lancet 2004;364:513-520.

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