[Breech Presentation--a problem of prematurity? (author's transl)].

The single breech deliveries at the Universitäts-Frauenklinik Insbruck from 1973 to 1977 have been reviewed. Related to a total number of 10.693 deliveries 390 children (3.6%) were born in breech presentation. The unselected perinatal mortality rate of infants in breech presentation was 7.0% which is 4 times higher than the total infant mortality (1.6%). This seems to be due to the higher prematurity rate with breech presentation compared to all deliveries (22.6% versus 8%). In 1977 only premature breeches have been lost. The perinatal mortality rate of premature infants with breech presentation is higher than those of premature babies with vertex presentation (26.3% versus 9.8%). Therefore, more care is needed for the prevention of premature labour in breech presentation. The Caesarean section rate because of breech presentation increased from 18% (1973) to 40% (1977); nevertheless the perinatal mortality rate couldn't be reduced. Up to the present we have been afraid of deliver large series of premature breeches by Caesarean section. Maybe that therefore the perinatal mortality rate couldn't be reduced. However, according to our results routinely performed Caesarean section with mature breeches is not justified. In our opinion a decrease of perinatal morbidity and mortality only can be obtained by reducing the premature breeches.