Discussion: Between 38 and 39 weeks of gestation, approximately 10% - 14% of women go into spontaneous labor;
meaning that a considerable number of women scheduled for an elective cesarean delivery at 39 weeks will deliver
earlier in an unscheduled, frequently emergency, cesarean delivery. The incidence of maternal morbidity and mortality
is higher among women undergoing non-elective cesarean deliveries than among those undergoing elective ones.
Complications may be greater among women after numerous repeat cesarean deliveries and among older women.
Other than reducing the frequency of non-elective cesarean deliveries, bringing forward the timing of elective
cesarean delivery to 38 weeks, may occasionally prevent intrauterine fetal demise which has been shown to increase
with increasing gestational age and to avoid other fetal consequences related to the emergency delivery. All these
considerations need to be weighed against the medical and the economic impact of the increase in neonatal
morbidity resulting from births at 38 weeks compared to 39 weeks.