Department of Obstetrics, University Hospital, Leipzig, Germany.
Department of Neonatology, University Hospital, Leipzig, Germany.
J Perinat Med. 2022 Jul 13;50(9):1248-1255. doi: 10.1515/jpm-2022-0202. Print 2022 Nov 25.
The safest mode of delivery for fetuses in breech presentations is still an ongoing debate. The aim of this study was to analyze neonatal admission rates after vaginal breech delivery and compare it to other modes of delivery in order to counsel pregnant women with breech presentation adequately.
We performed a retrospective monocentric analysis of all deliveries with singleton pregnancies in breech presentation > 36.0 weeks of gestation between 01/2018-12/2019. Short-term neonatal morbidity data was collected for vaginal delivery and primary as well as secondary cesarean sections from breech presentations.
A total of n=41/482 (8.5%) neonates had to be admitted to NICU: vaginal breech delivery n=18/153 (11.8%), primary cesarean section n=9/101 (8.9%, OR 0.73; CI 0.32-1.70; p=0.47), secondary cesarean section n=10/76 (13.2%, OR 1.14; CI 0.50-2.60, p=0.76) and vaginal vertex delivery n=4/152 (2.6%, OR 0.20; CI 0.06-0.51; p=0.005). There was no significant difference in transfer to NICU between all breech position delivery modes. Despite significantly lower pH and 5' APGAR values after vaginal delivery, neonates delivered by primary cesarean section and NICU admission had to be treated there significantly longer (mean 80.9 vs. 174.0 h). No significant difference in terms of ventilation parameters and infections were found between the vaginal delivery, primary and secondary cesarean section from breech presentation.
Vaginal breech delivery does not result in a higher neonatal admission rate in comparison to primary and secondary section. In contrast, there is a shorter NICU duration in case of neonatal admission after vaginal delivery.
对于臀位胎儿来说，最安全的分娩方式仍存在争议。本研究旨在分析经阴道臀位分娩后的新生儿入院率，并与其他分娩方式进行比较，以便为臀位孕妇提供充分的咨询。
我们对 2018 年 1 月至 2019 年 12 月期间所有>36.0 孕周单胎臀位妊娠的阴道分娩病例进行了回顾性单中心分析。收集了阴道分娩和经阴道分娩、初次剖宫产和二次剖宫产的新生儿短期发病率数据。
共有 41/482（8.5%）例新生儿需要入住新生儿重症监护病房：阴道臀位分娩 18/153（11.8%）例，初次剖宫产 9/101（8.9%，OR 0.73；95%CI 0.32-1.70；p=0.47），二次剖宫产 10/76（13.2%，OR 1.14；95%CI 0.50-2.60，p=0.76），阴道头位分娩 4/152（2.6%，OR 0.20；95%CI 0.06-0.51；p=0.005）。各种臀位分娩方式的新生儿转至新生儿重症监护病房的比例无显著差异。尽管阴道分娩后 pH 值和 5' APGAR 值明显较低，但行初次剖宫产和需要入住新生儿重症监护病房的新生儿在那里接受治疗的时间明显更长（平均 80.9 小时 vs. 174.0 小时）。阴道分娩、初次剖宫产和臀位二次剖宫产的新生儿通气参数和感染方面无显著差异。
与初次剖宫产和二次剖宫产相比，阴道臀位分娩并不会导致新生儿入院率升高。相反，阴道分娩后新生儿入院的新生儿重症监护病房停留时间更短。
