Incidence of cerebral dysfunction as a parameter for decision making in the management of preterm labor

The study presents a retrospective analysis of the data on pregnancy, delivery and cerebral dysfunction in 296 premature infants of singleton pregnancies, body weight > 1000 g, delivered at the Department of Obstetrics and Gynaecology in Novi Sad during 1997. Preterm newborns are exposed to a high risk of perinatal pathology, with 66.55% newborns from pathological course of pregnancy. Vaginal delivery--vertex presentation was registered in 69.93%, breech presentation in 6.41% and cesarean section in 23.65%. The preterm children have lower Apgar Scores and umbilical artery Ph values than term children. Cerebral dysfunction was diagnosed in 32.09%, whereas the incidence is inversely proportionate to gestational age and body weight at birth. The mode of delivery does not significantly affect cerebral dysfunction (p < 0.05) which means that intrapartal trauma is not a frequent cause of cerebral distress of preterm newborns. The labor occurring before the 34th gestational week can be performed vaginally if the fetus is either in vertex or complete breech presentation, if the course of labor is regular and cardiotocography findings within physiologic values.