Preterm breech delivery. Early and late complications

Area of Science:

• Obstetrics and Gynecology
• Neonatal Perinatal Medicine
• Pediatric Surgery

Background:

• Breech presentation in low birth-weight infants (<2500g) poses delivery challenges.
• Cesarean section rates for breech deliveries have varied historically.
• Perinatal outcomes for breech infants require careful evaluation.

Purpose of the Study:

• To compare vaginal and cesarean deliveries for singleton breech infants <2500g.
• To assess perinatal mortality and asphyxial morbidity in this cohort.
• To evaluate long-term sequelae in infants with low Apgar scores or birth injuries.

Main Methods:

• Retrospective analysis of 110 singleton breech infants (<2500g) delivered between 1972-1978.
• Comparison of outcomes (perinatal mortality, asphyxia) between vaginal and cesarean births.
• Follow-up of infants with low Apgar scores or birth trauma.

Main Results:

• Cesarean section rate was 30.1%.
• Two of three children with persistent sequelae related to delivery were identified.
• Cesarean section appeared beneficial for infants 1000-1500g; benefit was uncertain for infants 1500-2500g.
• Congenital anomaly rate was high at 13.6%.

Conclusions:

• Cesarean section is recommended for breech infants weighing 1000-1500g.
• The benefit of cesarean section for breech infants weighing 1500-2500g is questionable.
• High rates of congenital anomalies necessitate further investigation in breech presentations.