[Mode of delivery, postnatal condition and neonatal outcome in preterm infants]

There were under examination 578 preterm infants of two groups--28. up to 31. and 32. up to 36. week of gestation--after birth of vertex as well as breech prevention. Postnatal condition and neonatal outcome were put into relation to the mode of delivery. We compared Apgar-Score (one and five minute value), morbidity on respiratory distress syndrom as well as rate of survival and neonatal mortality in spontaneous delivery with and without episiotomia, with specula delivery, Shute-forceps and vacuum extraction of vertex presentation as well as with breech presentation after vaginal delivery and primary Caesarean section. In respect of the management of the second stage of labour it is our opinion that prophylactic additional measures in preterm delivery of vertex presentation after 32 weeks of gestation are not necessary and that this question should be examined in a larger study of much more cases. But we were able to demonstrate that up to 32. week of gestation well-timed episiotomia of optimal size is necessary. Our good experiences in breech presentation between 31. and 35. week of gestation treated by obligate Caesarean section have to prove true in future.