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[Early child morbidity and late development following primary abdominal cesarean section in breech presentation near
Insights
This study on children born via Cesarean section found no significant acidosis and minimal developmental delays. Early intervention using physiotherapy led to motor skill normalization in treated infants, highlighting the effectiveness of prompt rehabilitation.
Area of Science:
- Neonatal care
- Developmental pediatrics
- Obstetric outcomes
Context:
- Examines early morbidity and late development in infants born via primary low cervical Cesarean section before term.
- Analyzes risk factors including premature rupture, gestational diabetes, and anesthesia methods.
- Assesses neurodevelopmental outcomes using standardized tests like the Denver Developmental Screening Test.
Purpose:
- To evaluate the early morbidity and long-term neurodevelopmental outcomes of infants born via Cesarean section.
- To identify correlations between neonatal acidosis, Apgar scores, and risk factors.
- To assess the efficacy of early intervention strategies for developmental delays.
Summary:
- No clinically relevant acidosis was observed in newborns delivered by Cesarean section; however, 38% exhibited slight to moderate acidity.
- A correlation was found between high Apgar scores and normal umbilical artery blood acidity.
- Of 57 children followed up, one had speech delay and six showed mild motor disturbances, with four responding well to Bobath physiotherapy.
Impact:
- Highlights the generally favorable neonatal acid-base status in this cohort.
- Demonstrates the positive impact of early intervention and physiotherapy on neurodevelopmental outcomes.
- Provides insights into the long-term health trajectory of infants born via Cesarean section.
Abstract:
This study concerns the results obtained in respect of early morbidity and late development of 115 and 57 children, respectively, born between 1978 and 1983, who had been delivered by primary low cervical Caesarean section shortly before term. Early morbidity of the 115 children was analysed taking into consideration the risk factors, such as premature rupture, gestation diabetes, EPH gestosis, condition following Caesarean section, abnormal amnioscopic and antepartal cardiotocographic findings, as well as the methods of anaesthesia employed. In the study on late development 57 children between 1 1/4 and 6 years of age were followed up and examined with regard to several faculties (social contact, fine motoricity and adaptation, speech and gross motoricity) according to the Denver Developmental Screening Test. Children with abnormal findings were subjected to special examination. Children with abnormal findings were also subjected to a positional test according to Vojta and to the Munich functional developmental diagnosis after Hellbrüge et al. While employing physiotherapy after Bobath and early rehabilitation training by the parents, these children were followed up at regular intervals. There was no clinically relevant acidosis in the group of 115 newborn. A total of 44 newborn (38%) displayed slight to medium enhanced acidity (pH value, umbilical artery: 7.20 to 7.29) according to the stage classification after Saling and Wulf. Slight to medium acidosis (umbilical artery pH 7.10 to 7.19) was seen in 3 cases only (2.6%). In 112 newborn we found a correlation between the good Apgar score values (7-10) and normal acidity in the umbilical artery blood (act. umbilical artery pH greater than or equal to 7.30). In the remaining 3 newborn with lower Apgar scores (3-6) there was no acidosis in the umbilical artery blood. In the follow-up group (57 cases) we found one child with psychomotor retardation of speech (disturbed articulation and reduced vocabulary) and 6 children with slight motor disturbances in the early developmental stage. These disturbances were recorded as slight central disturbances of coordination according to Vojta within the framework of early diagnosis. Four of these children received early treatment according to Bobath. When they were between 1 and 1 1/2 years of age, all the 4 children showed normalisation of motoricity during the follow-up checks. The other two children displayed spontaneous regression of the mild central disturbance of coordination when they were 5 and 6 months of age.(ABSTRACT TRUNCATED AT 400 WORDS)