[Vaginal delivery in breech presentation does not increase early newborn morbidity. Results of 423 infants with breech presentation 1988-1992].

M Krause, A Gerede, T Fischer, A Feige
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Abstract

423 deliveries by breech presentation (1988-1992), delivered by vaginally or abdominally management, were analysed. 72 preterm (32nd to 36th gestational week) and 351 term labours were studied. In 239/423 (56.5%) cases neonates were delivered vaginally, in 54/423 (12.8%) and 130/423 (30.7%) cases primary or secondary cesarean section was necessary. In 120/423 (51.9%) cases of all primaparous spontaneously delivery were realized. There was no difference in early morbidity of vaginal und abdominal delivered neonates (pHNA, APGAR-Score, intracranially bleeding). Three intracranially bleedings (I degrees, II degrees, III degrees) observed in the vaginally delivery group (n = 239), were not the result of breech presentation or vaginally management. No correlation between vaginally management, acidosis and intracranially bleeding were observed. In patients presented with preterm labour (32nd to 36th gestational week) and/or fetal intrauterin growth retardation, cesarean section could be indicated. In postnatal sonographic screening of all neonates hip joint disorders were twice more frequently in female neonates (n = 51 vs. n = 26) without correlation to delivery mode. In conclusion, if certain personally and equipmently conditions are considered, vaginally delivery mode does not correlate to an increase of early neonatal morbidity.

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臀位阴道分娩不会增加新生儿早期发病率。[1988-1992] 423例婴儿臀位表现的结果。
分析了1988-1992年423例经阴道或腹部分娩的臀位分娩。研究了72例早产儿(32 ~ 36孕周)和351例足月分娩。239/423例(56.5%)新生儿顺产,54/423例(12.8%)和130/423例(30.7%)新生儿需要进行一次或二次剖宫产。120/423例(51.9%)患者均实现原产。阴道分娩和腹腔分娩新生儿的早期发病率(pHNA、apgar评分、颅内出血)无显著差异。顺产组(n = 239)出现3例颅内出血(I度、II度、III度),均非臀位或阴道处理所致。阴道处理、酸中毒与颅内出血无相关性。出现早产(孕32 ~ 36周)和/或胎儿宫内发育迟缓的患者,可行剖宫产。在所有新生儿的产后超声筛查中,女性新生儿髋关节疾病的发生率是女性新生儿的两倍(n = 51 vs. n = 26),与分娩方式无关。总之,如果考虑到某些个人和设备条件,顺产方式与早期新生儿发病率的增加无关。
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[Symposium on Uterine Contraction and Beginning of Labor. Aachen, September 1993]. [Uterine contraction and labor onset. Overview]. [Control of labor onset in the human]. [Biochemical principles of cervix ripening and dilatation]. [Role of the cervix uteri at labor onset from ultrasound studies].
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