[Morbidity and mortality in 1984-1985 of premature infants in breech presentation with a birth weight equal to or less than 1,500 g. A prospective study on the question of vaginal or abdominal delivery]

Abstract

The effect of the obstetrician's choice for delivery route on the early morbidity and mortality of very low birth weight infants in breech presentation (less than or equal to 1500 g) was studied prospectively in 22 children. Criteria of the morbidity were beside antenatal cardiotocogram, the Apgar-score at 1, 5 and 60 min., the cord venous pH-value and the duration of assisted ventilation after immediate delivery. From the first to 28th day of life we continuously analyzed the lowest oxygen pressure, the highest carbon dioxide pressure, therapy with NaHCO3 and the duration of assisted ventilation. But there were no significant differences in morbidity data and mortality between the newborn infants after vaginal and abdominal delivery. However the brief duration of assisted ventilation and brief ventilation time with a FiO2 greater than 0.3, after abdominal delivery were striking despite of a negative starting point of these children. For that reason we are of opinion that a well-timed abdominal delivery of very low birth weight infants in breech presentation shows a favourable influence on the normalization of metabolic and respirations data in the postnatal period and by this on the early morbidity.