Green J E, McLean F, Smith L P, Usher R
Am J Obstet Gynecol. 1982 Mar 15;142(6 Pt 1):643-8. doi: 10.1016/s0002-9378(16)32434-6.
To evaluate whether the dramatic rise in the cesarean section rate for breech presentation (from 22% in the decade 1963 to 1973 to 94% in 1978 and 1979) has been justified, 770 term breech deliveries at the Royal Victoria Hospital during the period 1963 to 1973 and during 1978 and 1979 have been reviewed. Neonatal outcome, as determined by one neonatologist during the entire period of this study, was analyzed according to vaginal or cesarean section breech deliveries of primiparous and multiparous women. For each method of delivery and state of parity the occurrence of asphyxia neonatorum, abnormal cerebral signs, postasphyctic congenital heart failure or renal failure, and intrapartum and neonatal deaths was studied. The most severe cases were individually reviewed. While breech presentation has become a virtual indication for cesarean section in many centers, to date , there has not been an evaluation of how effective this procedure is in reducing birth asphyxia and trauma. In this study we assessed whether the trend to perform cesarean section in all term breech presentations is justified and whether neonatal morbidity and mortality rates have actually improved as a result.
为评估臀位剖宫产率的急剧上升（从1963年至1973年这十年间的22%升至1978年和1979年的94%）是否合理，我们回顾了皇家维多利亚医院在1963年至1973年期间以及1978年和1979年期间的770例足月臀位分娩病例。由一名新生儿科医生在本研究的整个期间确定的新生儿结局，根据初产妇和经产妇的阴道或剖宫产臀位分娩情况进行了分析。对于每种分娩方式和产次状态，研究了新生儿窒息、异常脑体征、窒息后先天性心力衰竭或肾衰竭以及产时和新生儿死亡的发生情况。对最严重的病例进行了单独审查。虽然在许多中心臀位已几乎成为剖宫产的指征，但迄今为止，尚未对该手术在减少出生窒息和创伤方面的效果进行评估。在本研究中，我们评估了对所有足月臀位进行剖宫产的趋势是否合理，以及新生儿发病率和死亡率是否真的因此得到了改善。
