Neri Ruiz E S, Valerio Castro E, Cárdenas Arias R, Navarro Milla C
Hospital Central Militar, Méx., D.F.
Ginecol Obstet Mex. 1997 Nov;65:474-7.
During one year, 104 term products were in fetal presentation. Cesarean was done in 75%, and most frequent indications were, deflexionated head (24.2%); previous section 24.2%; head hyperextension 12.8%. Section was done only in 14.4% of product with the requisites for vaginal delivery. There were two neonate al deaths among the ones by vaginal via; one due to major congenital malformations. Corrected neonatal mortality was 34.4 for 1000 alive products. Severe perinatal asphyxia was in 0.76% in vaginal birth and in 0.38% of cesarean products; and difference was not statistically significant. Maternal morbidity was 20.3% in cesarean and 0% for vaginal delivery. In the cases with pelvic presentation, well selected for vaginal delivery, fetal morbidity was not significantly increased, and maternal morbidity decreases importantly. In selected patients and with well trained physicians for this purpose, vaginal delivery is a good option.
在一年中,104例足月产呈胎儿先露。剖宫产率为75%,最常见的指征是:胎头俯屈(24.2%);既往剖宫产史(24.2%);胎头过度伸展(12.8%)。仅14.4%具备阴道分娩条件的产妇进行了剖宫产。经阴道分娩的新生儿中有2例死亡;1例死于严重先天性畸形。校正后每1000例存活新生儿的死亡率为34.4。经阴道分娩的严重围产期窒息率为0.76%,剖宫产儿为0.38%;差异无统计学意义。剖宫产的产妇发病率为20.3%,阴道分娩为0%。对于选择经阴道分娩的臀先露病例,胎儿发病率没有显著增加,产妇发病率则显著降低。对于经过精心挑选且医生受过相关良好培训的患者,阴道分娩是一个不错的选择。