Studies on the mode of delivery and the outcome of small preterm infants with less than 32 weeks of gestation.

The purpose of this study is to make the relationship clear between the mode of delivery and the outcome of small preterm infants. A total of 91 tiny infants who were delivered before 32 weeks of gestation at Seirei Hamamatsu Hospital (between July 1, 1977 and January 31, 1983) and were studied retrospectively. Mean and standard deviation of birth weight and gestational age were 1215 +/- 388 grams and 28.2 +/- 2.4 weeks. The following results were obtained in the present study: 1) breech vaginal delivery of a tiny infant was a associated with an alarmingly high neonatal mortality rate, 2) infants weighing less than 750 grams had a very low survival rate among any of the modes of delivery, 3) infants delivered before 28 weeks of gestation had a poor survival rate, 4) an elective cesarean section of the infants weighing between 750 and 1499 grams showed a lower 28 days mortality rate than an emergency cesarean section or a breech vaginal delivery, though there were no statistical differences between a cephalic vaginal delivery and an elective cesarean section, 5) the frequency of intracranial hemorrhage was significantly lower among the elective cesarean sections than the others.