DELIVERY OF THE VERY-LOW-BIRTH-WEIGHT BREECH - WHAT IS THE BEST WAY FOR THE BABY

A retrospective analysis was done to determine whether vaginally vs. c esarean section-born breech infants in the very low birthweight range are at increased risk for morbidity and mortality. Eighty-three viable singleton breech infants weighing 700-1,600 g, who were delivered in our medical center during the period 1980 through 1993, were followed for up to 5 years of age. Analysis of data after correction for weight , gestational age and other confounding variables such as antepartum c omplications revealed that survival rates in the 700-1,000 g group wer e similar in both routes of delivery. In the 1,001-1,600 g group, surv ival rate was 60.9% after vaginal delivery, as compared to 100% after cesarean section (P <0.01). No difference was demonstrated in long-ter m outcome between the vaginal and cesarean groups, although the popula tion was too small to draw statistical conclusions. Considering the li mitation of such a retrospective analysis, our data identified a trend that supports prophylactic cesarean section in cases of pre-term bree ch infants weighing 1,000-1,600 g.