[In Process Citation]

Abstract

OBJECTIVE: The objective of this retrospective analysis was to compare the obstetrical procedures at premature birth and delivery at term. The aim was to show the influence of gestational time on mode of delivery and neonatal state. MATERIAL AND METHODS: 339 births from breech presentation between 1988-1990 were compared with premature births and deliveries at term. RESULTS: Frequency of breech presentation totalled 4.1%. 173 deliveries (51.7%) resulted vaginally, 26 cases (7.8%) with freeing of arms and 4 cases (1.2%) as extraction. Frequency of cesarean sections totalled 48.3%. The number of premature births reached in the group of breech presentation 23.1%. Births at term resulted with 58% predominantly vaginally (abdominally in 42%). Between the 31st and 36th gestational week the number of cesarean sections rose to 67.3%, in the 31st week it even reached 78.9%. The neonatal state was described with the help of Apgar-scores and umbilical cord-pH-values. The share of newborns with optimal Apgar-values after 1 minute (8-10) was in premature births with 36.5% only about half as large as in deliveries at term (77.6%). Only 9.6% of the children showed pH-values below 7.20. Number of newborns with these pH-values totalled in premature births in the 31st week 35.3%, for terms between the 31st and 36th week 15.6%, and declined in mature births to only 6.2%. CONCLUSIONS: Estimating the neonatal state of the group of breech presentations the vaginal birth should keep an equal rank in the delivery plan of a clinic. At the appraisal of the childlike early morbidity of a delivery group the number of premature newborns is decisive.