Krupitz Hartmut, Arzt Wolfgang, Ebner Thomas, Sommergruber Michael, Steininger Erwin, Tews Gernot
Landes-Frauen- und Kinderklinik, Abteilung für Geburtshilfe, Linz, Austria.
Acta Obstet Gynecol Scand. 2005 Jun;84(6):588-92. doi: 10.1111/j.0001-6349.2005.00845.x.
The Term Breech Trial (TBT), a well-known study conducted by Hannah and published in the Lancet, revealed a better outcome for neonates after primary caesarean section compared with attempted vaginal delivery. The aim of the present study was to determine whether the results of TBT have to be taken into account when counseling pregnant women in central Europe.
We investigated 882 women who had delivered infants in breech presentation over a period of 11 years. The neonates had a birthweight of >2500 g and no malformations. We compared mortality and serious neonatal morbidity after attempted vaginal delivery and after primary caesarean section.
No infant or maternal mortality was registered in either group. Serious neonatal morbidity was higher (0.5%; n = 2) for attempted vaginal delivery than for primary caesarean section; in the latter group, no child fulfilled the criteria for serious neonatal morbidity. However, the difference was not statistically significant. As expected, after attempted vaginal delivery, the base excess, and 5-min APGAR scores were indicative of more markedly depressed children.
After careful exclusion of risk factors and informing the patient in detail about the risks and possible complications, vaginal delivery from breech presentation is still warrantable.
“臀位分娩试验”（TBT）是一项由汉娜开展并发表于《柳叶刀》杂志的著名研究，该研究表明，与尝试经阴道分娩相比，初次剖宫产术后新生儿的结局更好。本研究的目的是确定在为中欧地区的孕妇提供咨询时是否必须考虑TBT的结果。
我们调查了882名在11年期间分娩臀位婴儿的女性。这些新生儿出生体重>2500g且无畸形。我们比较了尝试经阴道分娩和初次剖宫产术后的新生儿死亡率和严重新生儿发病率。
两组均未记录到婴儿或产妇死亡。尝试经阴道分娩的严重新生儿发病率（0.5%；n=2）高于初次剖宫产；在后一组中，没有儿童符合严重新生儿发病率的标准。然而，差异无统计学意义。正如预期的那样，尝试经阴道分娩后，碱剩余和5分钟阿氏评分表明儿童的抑郁程度更明显。
在仔细排除风险因素并向患者详细告知风险和可能的并发症后，臀位经阴道分娩仍然是可行的。
