Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul 34668, Turkey.
Arch Gynecol Obstet. 2012 Feb;285(2):297-303. doi: 10.1007/s00404-011-1956-0. Epub 2011 Jul 7.
To compare maternal and neonatal outcomes of the vaginal delivery versus cesarean delivery for the breech presentation.
We reviewed the maternal and neonatal charts of all singleton breech deliveries of <1,000, 1,000-1,500, 1,501-2,500, 2,501-4,000, and >4,000 g delivered between 2000 and 2006 at our institution. The study population consisted of 1,537 women with a fetus in a breech presentation. A group of 478 women that had delivered vaginally was compared with a group of 1,059 women, who had cesarean delivery, regarding neonatal mortality and morbidity (asphyxia, bone fractures, intraventricular hemorrhage, convulsions, respiratory distress syndrome, necrotizing enterocolitis, congenital hip dislocation), and maternal morbidity (febrile morbidity, anemia, wound infection).
Neonatal complications did not differ between the group of women with term babies, <1,000 g babies, >1,500 g babies in breech presentation for women that had vaginal delivery and those that had cesarean delivery. On the other hand, breech presentation in preterm delivery between 1,000 and 1,500 g birth weight appears an independent risk factor for the neonatal mortality. There were fewer maternal complications in the vaginal group than in the cesarean group.
Vaginal delivery of 1,000-1,500 g babies presenting as breech is associated with the increased neonatal mortality compared with cesarean delivery. Cesarean delivery is associated with maternal morbidity compared with the vaginal delivery.
比较臀位分娩与剖宫产分娩的母婴结局。
我们回顾了 2000 年至 2006 年间在我院出生的体重<1,000g、1,000-1,500g、1,501-2,500g、2,501-4,000g 和>4,000g 的单胎臀位分娩的产妇和新生儿病历。研究人群包括 1537 名臀位分娩的产妇。比较了 478 名阴道分娩的产妇与 1059 名剖宫产的产妇的新生儿死亡率和发病率（窒息、骨折、颅内出血、惊厥、呼吸窘迫综合征、坏死性小肠结肠炎、先天性髋关节脱位）以及产妇发病率（发热、贫血、伤口感染）。
在足月婴儿、<1,000g 婴儿、>1,500g 婴儿的臀位分娩中，阴道分娩组和剖宫产组的新生儿并发症无差异。另一方面，1,000-1,500g 出生体重的早产臀位分娩是新生儿死亡的独立危险因素。阴道分娩组的产妇并发症少于剖宫产组。
与剖宫产相比，1,000-1,500g 臀位分娩的新生儿死亡率更高。与阴道分娩相比，剖宫产与产妇发病率有关。
