Preterm caesarean section

Summary. A retrospective study of 1921 caesarean sections at Rutherglen Maternity Hospital in Glasgow during the years 1979–1983, inclusive, showed that 229 (12%) were performed at less than 37 weeks gestation. Of these 229 preterm caesarean sections 41% were elective, 21% were for antepartum haemorrhage and 38% took place during labour. Of the 254 babies born 18 (7%) died in the neonatal period. These deaths comprised 31% of all neonatal deaths during the study period in this hospital. The neonatal death rate was 70% for babies weighing <1000 g (7 of 10) and 23% for babies weighing 1000–1500 g (6 of 26), but only 3% for babies heavier than this (7 of 217). Of the 75 women with a subsequent pregnancy after the preterm caesarean section 56% were again delivered by caesarean section. In view of the maternal morbidity associated with caesarean section and the poor neonatal outcome at birthweights of <1500g, the use of operative delivery for very low birthweight infants deserves further scrutiny.