[Neonatal dead and method of delivery < or = 32 weeks of gestation].

ABSTRACT

UNLABELLED The purpose of this study is to determine the dependence of neonatal dead by method of delivery at prematurity. MATERIAL AND METHODS: Prospective study on 238 single births from 25-32 g.w. According to the method of delivery and fetal presentation newborns are divided into the following groups vertex presentation - vaginal birth (PN) and Cesarean section (SC) and breech presentation - PN and SC. RESULTS: For the period, in the first 28 days after birth died 42 (17,7%) infants and 196 (82,3%) were survivors. Depending on the mode of birth statistically significant difference in the incidence of death after birth is not found in vertex presenting newborns (25% CS vs. 16,5% PN; p > 0.05). Unlike in breech presenting fetuses, vaginal birth < or = 32 weeks increases more than twofold neonatal dead compared with CS (20% vs. 7,7%; p < 0.05). Unfavourable outcome in CS is strongly associated with fetal presentation - three times higher neonatal dead in vertex presenting group (25% vs. 7, 7%; p < 0.05), as a result of higher incidence of absolute fetal indications (68,1% vs. 43,2%; p< 0.05). CONCLUSION: The way of birth doesn't affect the frequency of dead within the first 28 days of life in vertex presenting fetuses. Vaginal breech delivery is a risk factor for unfavourable neonatal outcome < or = 32 w.g. Survival in CS is dependent on both fetal presentation and obstetric complications, requiring operation.