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[Management of preterm breech presentation]
1Klinika za zenske bolesti i porode, Mediciniski fakultet, Zagreb.
At the department for Obstetrics and Gynecology in Zagreb we analyzed 342 preterm singleton breech deliveries during three different periods of time: the first from 1975-1978, the second from 1982-1986, and the most recent one from 1987-1989. All studied cases were infants with birth weight of 1.200 gr or more. Out of 135 infants born in the first time interval, the Bracht maneuver was employed in 90 (66.6%) cases; 13.3% of vaginal deliveries from the same time interval were managed by partial extraction, and total etraction was applied in 3.7% of vaginal deliveries. The cesarean delivery rate was 16.3% in the first analyzed period. From 1982-1986, 79 (67.5%) out of a total of 117 infants were delivered vaginally by the Bracht maneuver, 3.4% by partial extraction, and only one child was delivered by total extraction. In this time interval, 28.2% of all deliveries were terminated by cesarean section. In the most recent interval from 1987-89, our attitude towards preterm breech delivery has completely changed. The Bracht maneuver was applied in only 32.2% out of a total of 90 born infants, and partial extraction in 3.3%. None of the infants were delivered by total extraction. The cesarean section rate doubled and amounted to 64.4%. Nevertheless, the best indicator of results is the perinatal mortality of infants according to the observed time intervals. Perinatal mortality in the first period was 20%, in the second period it was 12% and 5.6% in the third period.(ABSTRACT TRUNCATED AT 250 WORDS)
At the department for Obstetrics and Gynecology in Zagreb we analyzed 342 preterm singleton breech deliveries during three different periods of time: the first from 1975-1978, the second from 1982-1986, and the most recent one from 1987-1989. All studied cases were infants with birth weight of 1.200 gr or more. Out of 135 infants born in the first time interval, the Bracht maneuver was employed in 90 (66.6%) cases; 13.3% of vaginal deliveries from the same time interval were managed by partial extraction, and total etraction was applied in 3.7% of vaginal deliveries. The cesarean delivery rate was 16.3% in the first analyzed period. From 1982-1986, 79 (67.5%) out of a total of 117 infants were delivered vaginally by the Bracht maneuver, 3.4% by partial extraction, and only one child was delivered by total extraction. In this time interval, 28.2% of all deliveries were terminated by cesarean section. In the most recent interval from 1987-89, our attitude towards preterm breech delivery has completely changed. The Bracht maneuver was applied in only 32.2% out of a total of 90 born infants, and partial extraction in 3.3%. None of the infants were delivered by total extraction. The cesarean section rate doubled and amounted to 64.4%. Nevertheless, the best indicator of results is the perinatal mortality of infants according to the observed time intervals. Perinatal mortality in the first period was 20%, in the second period it was 12% and 5.6% in the third period.(ABSTRACT TRUNCATED AT 250 WORDS)