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Term breech and long-term morbidity -- cesarean section versus vaginal breech delivery
K Münstedt1, R von Georgi, S Reucher
1Medical Center for Obstetrics and Gynecology, Philipps-University Marburg, Pilgrimstein 3, 35033 Marburg, Germany. muensted@post.med.uni-marburg.de
Study:
Perinatal morbidity and mortality of term fetuses have been discussed extensively both for vaginal breech delivery and cesarean section. However, information regarding long-term morbidity and psychomotoric development of these children are scarce.
Design:
Data of 154 children delivered after breech presentation at our institution between 1988 and 1994 were analyzed using a specific, standardized questionnaire (Enzephalopathiefragebogen, Meyer-Probst) with emphasis on psychomotoric development and skills. Hyperkinetic disorders, social adaptation, emotional instability, and intelligence were evaluated as subcategories and compared to perinatal data.
Results:
pO(2) and base excess (BE) in the umbilical artery were lower in the vaginal group. pH, body weight and placental weight showed no difference between groups. Psychomotoric development and skills did not differ between children delivered vaginally or abdominally. Perinatal variables did not allow a prediction of long-term morbidity.
Conclusion:
Route of delivery has negligible influence on the measured values in the umbilical artery and no influence on long-term morbidity of fetuses presenting breech.