Wulf K H, Kastendieck E, Seelbach-Göbel B
Z Geburtshilfe Perinatol. 1984 Nov-Dec;188(6):249-55.
In regard to the present perinatal mortality for prematures with cephalic presentation, a general cesarian section below certain limits in weight and gestation cannot be recommended. The management of prematurity must be individualized and depends on additional risk factors. In case of doubt, the abdominal delivery is to prefer especially in a patient with less than 32 weeks of gestation or an estimated fetal weight of 1500 g or less. At least a potential risk for the fetus by anaesthesia and surgery has also to be considered. Vaginal delivery is justifiable especially in patients with unruptured membranes, high pelvic score and expected rapid delivery and with no additional fetal or maternal risk factors. Special attention must be paid to a gentle delivery of the head. These statements are based on present data of fetal mortality and probably of the same significance for fetal morbidity, especially the development of intraventricular hemorrhage.
关于目前头先露早产儿的围产期死亡率，不建议对体重和孕周低于一定限度的情况常规行剖宫产。早产的处理必须个体化，且取决于其他风险因素。如有疑问，尤其对于孕周小于32周或估计胎儿体重1500克及以下的患者，应优先选择剖宫产。同时还必须考虑麻醉和手术对胎儿至少存在的潜在风险。阴道分娩是合理的，特别是对于胎膜未破、骨盆评分高且预计分娩迅速且无其他胎儿或母亲风险因素的患者。必须特别注意轻柔娩出胎头。这些陈述基于目前的胎儿死亡率数据，对胎儿发病率可能也具有同样的意义，尤其是脑室内出血的发生。
