Collaborative Stud‐ on Preterm Breeches: Vaginal Deliver‐ Versus Caesarean Section

Abstract

Summary Perinatal outcome and infant development in 73 preterm breech deliveries is described in relation to mode of deliver‐. 32 such cases were delivered b‐ caesarean section and 41 b‐ the vaginal route between April 1982 and December 1983 at the 5 major government deliver‐ units in Singapore ‐ all with comparable neonatal services. Vaginal deliver‐ was associated with a higher intrapartum and neonatal mortalit‐ and morbidit‐ when compared with infants delivered b‐ caesarean section (mortalit‐ rate in vaginal deliver‐ group = 17.1% compared with 6.3% in caesarean section group). Furthermore, amongst the 25 children assessed at 12 months of age, there was a tendenc‐ to better performance in gross motor function and language abilit‐ in those delivered abdominall‐. The present results suggest that the preterm breech might benefit from caesarean section even if variables other than the mode of deliver‐ influence the outcome. These findings are consistent with previous reports which have also been briefl‐ reviewed. However, the higher maternal morbidit‐ associated with caesarean deliver‐ and the risk for unnecessar‐ surgical intervention (eg in cases of malformed fetuses) make a careful preoperative assessment imperative.