García García Inés E, de la Vega Alberto, García Fragoso Lourdes
Department of Pediatrics, Neonatology Section, Medical Sciences Campus, PO Box 365067, San Juan, Puerto Rico 00936-5067.
P R Health Sci J. 2002 Sep;21(3):253-5.
Cesarean section is a common delivery route for breech fetuses < 1000 gm to prevent trauma. However, abdominal and vaginal delivery maneuvers are similar. Cesarean section avoids the risk of head entrapment but long bone trauma can still occur.
We identified three neonates with femoral fractures during a one year period. All mothers were in active labor. All were premature newborns less than 32 weeks gestation, in breech presentation and delivered by a low vertical cesarean section. Review of all cesarean sections done due to mal presentation (n = 26) during that time showed 11 classic and 15 lower segment vertical incisions (both vertical and transverse).
The interest to reduce maternal morbidity may prompt physicians to perform a low segment vertical incision for delivery of a preterm breech. This decision may increase the chances of trauma by providing less area for the required obstetric maneuvers.
剖宫产是体重小于1000克臀位胎儿常见的分娩途径，以预防创伤。然而，剖宫产和阴道分娩操作相似。剖宫产可避免头部嵌顿风险，但长骨创伤仍可能发生。
我们在一年期间发现了3例股骨骨折的新生儿。所有母亲均处于活跃期分娩。所有患儿均为孕周小于32周的早产儿，臀位，通过低位垂直剖宫产分娩。回顾同期因胎位异常行剖宫产的所有病例（n = 26），发现11例为经典切口，15例为下段垂直切口（包括垂直和横切口）。
降低产妇发病率的意愿可能促使医生对早产臀位胎儿采用低位垂直切口分娩。这一决定可能因提供的产科操作空间较小而增加创伤几率。
