MANAGEMENT OF LOW-BIRTH-WEIGHT BREECH DELIVERY - SHOULD CESAREAN-SECTION BE ROUTINE

Abstract

A total of 434 low birth weight deliveries were studied retrospectively. Of these, 217 were breech deliveries, and the other 217 constituted a control series of vertex deliveries. In the breech deliveries the perinatal mortality was 1.8 times that of the cephalic cases, and the neonatal mortality was 2.9 times greater. During the last 5 yr of the study, the cesarean section rate increased for the group of infants weighing between 1500-2499 g; this policy did not improve the prognosis in breech presentations. Malformations and respiratory distress syndrome were more frequent in breech presentations. Conditions associated with the corrected perinatal mortality (cerebral hemorrhage, fetal asphyxia, prolapsed cord) were also more common in breech presentations, but especially in the group of infants weighing less than 1500 g. This weight group, for which the cesarean section rate did not rise, emerged as a special area of concern. Conclusions and recommendations for management are presented.