[The mode of delivery and neonatal outcome in breech presentations less than 32 weeks' of gestation]
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This study was undertaken to determine the effect of the delivery method on neonatal outcome in fetal breech presentation, and the following results were obtained. The rate of cesarean section for breech presentations was 70.7% (104/147). 1) There were 18 neonatal deaths (41.9%) in 43 vaginal breech deliveries compared to 8 (7.7%) in 104 cesarean breech deliveries. Neonatal deaths were significantly higher in vaginal breech deliveries than cesarean breech deliveries (p less than 0.001). 2) In breech presentations, intracranial hemorrhages were more common among vaginally born infants (44.2% vs. 25.0%; p less than 0.02), but the incidence of idiopathic respiratory distress syndrome (39.5% vs. 28.8%) did not differ significantly between vaginal and cesarean infants. 3) In singletons delivered vaginally, fetal distress was more common among breech presentations than vertex presentations (83.3% vs. 46.3%; p less than 0.02). 4) In vaginally delivered breech singletons, there was no neonatal death among infants with more than 4 one minute Apgar scores, and there was no significant difference between neonatal death and the no neonatal death groups with regard to gestational weeks and birth weight.
This study was undertaken to determine the effect of the delivery method on neonatal outcome in fetal breech presentation, and the following results were obtained. The rate of cesarean section for breech presentations was 70.7% (104/147). 1) There were 18 neonatal deaths (41.9%) in 43 vaginal breech deliveries compared to 8 (7.7%) in 104 cesarean breech deliveries. Neonatal deaths were significantly higher in vaginal breech deliveries than cesarean breech deliveries (p less than 0.001). 2) In breech presentations, intracranial hemorrhages were more common among vaginally born infants (44.2% vs. 25.0%; p less than 0.02), but the incidence of idiopathic respiratory distress syndrome (39.5% vs. 28.8%) did not differ significantly between vaginal and cesarean infants. 3) In singletons delivered vaginally, fetal distress was more common among breech presentations than vertex presentations (83.3% vs. 46.3%; p less than 0.02). 4) In vaginally delivered breech singletons, there was no neonatal death among infants with more than 4 one minute Apgar scores, and there was no significant difference between neonatal death and the no neonatal death groups with regard to gestational weeks and birth weight.