Gimovsky M L, Petrie R H, Todd W D
Obstet Gynecol. 1980 Dec;56(6):687-91.
Several authorities have recommended cesarean section for all intrapartum breech presentations. The present study documents that judiciously selected fetuses at term in breech presentation may be safely delivered vaginally by a selective management protocol that requires cesarean section when mandated criteria are not met. The outcome and performance of 6 years of vaginal breech deliveries were evaluated. Those in the control groups were delivered by spontaneous vertex vaginal and elective repeat cesarean section procedures. Morbidity was not different in the protocol breech vaginal delivery group and in the controls. Mortality was found only in the nonprotocol-managed breech vaginal delivery group, which also had a morbidity 5 times greater than that of controls. Approximately half the term breech presentations that are properly selected and managed may be safely delivered vaginally, thereby avoiding a significant number of cesarean sections and subsequent inherent risks.
几位权威人士建议对所有分娩期臀位产妇进行剖宫产。本研究记录了，足月臀位的胎儿经审慎挑选后，可通过选择性管理方案安全地经阴道分娩，该方案要求在不符合规定标准时进行剖宫产。对6年经阴道臀位分娩的结果和操作情况进行了评估。对照组通过自然头位阴道分娩和选择性重复剖宫产手术分娩。方案组经阴道臀位分娩组与对照组的发病率没有差异。仅在非方案管理的经阴道臀位分娩组中发现有死亡病例，该组的发病率也比对照组高5倍。大约一半经过适当挑选和管理的足月臀位产妇可以安全地经阴道分娩，从而避免大量剖宫产及其后续的固有风险。
