Preterm caesarean section

A retrospective study of 1921 caesarean sections at Rutherglen Maternity Hospital in Glasgow during the years 1979-1983, inclusive, showed that 229 (12%) were performed at less than 37 weeks gestation. Of these 229 preterm caesarean sections 41% were elective, 21% were for antepartum haemorrhage and 38% took place during labour. Of the 254 babies born 18 (7%) died in the neonatal period. These deaths comprised 31% of all neonatal deaths during the study period in this hospital. The neonatal death rate was 70% for babies weighing less than 1000 g (7 of 10) and 23% for babies weighing 1000-1500 g (6 of 26), but only 3% for babies heavier than this (7 of 217). Of the 75 women with a subsequent pregnancy after the preterm caesarean section 56% were again delivered by caesarean section. In view of the maternal morbidity associated with caesarean section and the poor neonatal outcome at birthweights of less than 1500 g, the use of operative delivery for very low birthweight infants deserves further scrutiny.