[Changes in breech delivery].

Abstract

From 1965 to 1981, 1042 singlets born in breech position were recorded out of 25,004 deliveries, at the München-Harlaching City Hospital. The Caesarean section rate was of 48.3%, the perinatal mortality of children weighing more than 1000 g was 3.8%, the perinatal mortality of prematures born in breech position was 19.7%. We subdivided our group of patients in two subgroups: 500 breech deliveries from 1965-1973, and 542 breech deliveries from 1973-1981. In the first subgroup, the Caesarean section rate was 38%, the perinatal mortality 5.6%, and the perinatal mortality of prematures born in breech position 29.6%. In the second subgroup, the Caesarean section rate was of 57.7%, the perinatal mortality was 2.2%, and the perinatal mortality of premature breech deliveries 8.4%. Since the prospective management of delivery, the perioperative conditions, the reanimation possibilities, and the close contact to a newborn intensive care unit, remained unchanged throughout the entire observation period, we tend to correlate the different results obtained in the both subgroups with the different Caesarean section rates recorded. We therefore consider that the consistent prospective delivery management with ample indication to Caesarean section, is also in the Management of a breech delivery even more important than the obliged indication to Caesarean section.