Collaborative Stud- on Preterm Breeches: Vaginal Deliver- Versus Caesarean Section


Universit- Department of Obstetrics and G-naecolog-, Kandang Kerbau Hospital, Hanpshire Road, Singapore 0821


Perinatal outcome and infant development in 73 preterm breech deliveries is described in relation to mode of deliver-.

32 such cases were delivered b- caesarean section and 41 b- the vaginal route between April 1982 and December 1983 at the 5 major government deliver- units in Singapore - all with comparable neonatal services.

Vaginal deliver- was associated with a higher intrapartum and neonatal mortalit- and morbidit- when compared with infants delivered b- caesarean section (mortalit- rate in vaginal deliver- group = 17.1% compared with 6.3% in caesarean section group). Furthermore, amongst the 25 children assessed at 12 months of age, there was a tendenc- to better performance in gross motor function and language abilit- in those delivered abdominall-. The present results suggest that the preterm breech might benefit from caesarean section even if variables other than the mode of deliver- influence the outcome. These findings are consistent with previous reports which have also been briefl- reviewed.

However, the higher maternal morbidit- associated with caesarean deliver- and the risk for unnecessar- surgical intervention (eg in cases of malformed fetuses) make a careful preoperative assessment imperative.