Cesarean section versus vaginal delivery for the breech fetus weighing less than 1,500 grams

Although previous studies have suggested that the breech infant weighing less than 1,500 gm benefits from cesarean section, the published results have not demonstrated statistically significant differences. We have evaluated pediatric outcome data for 240 breech infants and 525 vertex infants who weighed less than 1,500 gm, to determine whether route of delivery affects infant morbidity and mortality. Twenty-nine percent of these very small breech infants who were delivered by cesarean section died, as compared to 58% of breech infants of similar weight who were delivered vaginally (p less than 0.001). Comparable significant differences were found for the infants delivered at a university hospital as well as for those delivered at a group of nonuniversity hospitals. Apgar scores and the incidence and severity of intraventricular hemorrhage were not different for the cesarean section and vaginally delivered breech infants. Furthermore, the survival rate of the breech infants delivered by cesarean section equaled that of the vertex infants delivered either by cesarean section or vaginally.