Vaginal breech delivery in very low birth weight (VLBW) neonates: experience of a single center

Abstract

Neonatal outcome is not improved in VLBW infants born by cesarean section. Given the morbidity of classical cesarean sections, vaginal delivery of the breech VLBW infant may be safely considered.

Management of Extremely Preterm Births in the Level III Maternity Unit at Strasbourg University Hospital Centre (CHU)

“…In their analysis, Werner et al [38] concluded that for low-birth weight neonates and preterms at 28-32WG, the delivery method did not modify the neonatal condition, but that for terms of less than 26WG, vaginal delivery accounted for only 1% of the cohort studied although it was strongly preferred. A retrospective study conducted between 1994 and 2003 in 2466 vertexpresenting singleton new-borns weighing less than 1500g compared vaginal and caesarean births [39]. In the specific subpopulation of neonates of gestational age <26 WG (n=439), caesarean showed no advantage in terms of neonatal mortality (OR 0.89; 95% CI: 0.54-1.46) [39].…”

“…A retrospective study conducted between 1994 and 2003 in 2466 vertexpresenting singleton new-borns weighing less than 1500g compared vaginal and caesarean births [39]. In the specific subpopulation of neonates of gestational age <26 WG (n=439), caesarean showed no advantage in terms of neonatal mortality (OR 0.89; 95% CI: 0.54-1.46) [39]. With regard to morbidity in the overall cohort, caesarean was reported not to confer any benefit for either infectious risk (OR 0.78; 95%CI: 0.61-1.01) or risk of respiratory distress (RR 1.23 [0.99-1.51]), although there was a benefit relating to the risk of cerebral haemorrhage (OR 0.73; 95% CI: 0.55-0.97) [40].…”

How are Premature Babies Born?

“…Stohl et al (44) reported that maternal morbidities (hemorrhage and postpartum infection) were more common in mothers with fetal breech presentation and who gave birth via cesarean section.…”

Optimal delivery for preterm breech fetuses: is there any consensus?

“…Of the caesarean deliveries, 27 involved classical uterine incisions with higher estimated blood loss (732 mL vs 362 mL on average) and postpartum infection rates (26% vs 4%). 11 Thus, caesarean section was apparently associated with higher maternal morbidity and no neonatal benefits.…”