Weisbach W, Menzel K, Wagner F, Bratanoff E, Jäger K H
Zentralbl Gynakol. 1986;108(7):424-34.
The effect of the obstetrician's choice for delivery route on the early morbidity and mortality of very low birth weight infants in breech presentation (less than or equal to 1500 g) was studied prospectively in 22 children. Criteria of the morbidity were beside antenatal cardiotocogram, the Apgar-score at 1, 5 and 60 min., the cord venous pH-value and the duration of assisted ventilation after immediate delivery. From the first to 28th day of life we continuously analyzed the lowest oxygen pressure, the highest carbon dioxide pressure, therapy with NaHCO3 and the duration of assisted ventilation. But there were no significant differences in morbidity data and mortality between the newborn infants after vaginal and abdominal delivery. However the brief duration of assisted ventilation and brief ventilation time with a FiO2 greater than 0.3, after abdominal delivery were striking despite of a negative starting point of these children. For that reason we are of opinion that a well-timed abdominal delivery of very low birth weight infants in breech presentation shows a favourable influence on the normalization of metabolic and respirations data in the postnatal period and by this on the early morbidity.
对22例臀位极低出生体重儿（小于或等于1500克）前瞻性研究了产科医生选择的分娩途径对其早期发病率和死亡率的影响。发病率标准除产前胎心监护外，还包括出生后1分钟、5分钟和60分钟的阿氏评分、脐静脉血pH值以及即刻分娩后辅助通气的持续时间。从出生第1天到第28天，我们持续分析最低氧分压、最高二氧化碳分压、碳酸氢钠治疗情况以及辅助通气的持续时间。但是，经阴道分娩和经腹分娩的新生儿在发病率数据和死亡率方面没有显著差异。然而，尽管这些患儿起始情况不佳，但经腹分娩后辅助通气持续时间较短，且在吸入氧浓度大于0.3时通气时间较短。因此，我们认为，对臀位极低出生体重儿适时进行经腹分娩，对出生后代谢和呼吸数据的正常化有有利影响，进而对早期发病率有有利影响。
