PROGRESS OF LABOR AND NEONATAL MORBIDITY IN PRIMIGRAVID BREECH BIRTH

Progress of labour in 100 consecutively delivered term (greater than o r equal to 37 weeks) primiparous breech births was analysed and correl ated with fetal outcome according to different durations of first and second stages. All women had sonographic biometry prior to admission a nd epidural anaesthesia (PDA) early in established labour. Women with nonreassuring fetal heart rate tracings during any stage of labour wer e delivered by caesarean section, and were excluded. Birth weights wer e between 1980 g and 4090 g. There was no perinatal mortality, but eig ht neonates sustained birth-associated trauma (6 Erb's palsies, two fr actured long bones), all of which regressed spontaneously. Risk of neo natal trauma and of reduced Apgar scores was significantly associated with duration of the first stage but not of the second stage. it appea rs that short first stage duration (i.e. up to six hours) or a cervica l dilatation rare of no less than 1 cm/h is associated with a very low risk of fetal trauma. In contrast, no upper limit of a second stage d uration associated with low trauma risk could be seen in this group of parturients with effective continuous epidural anaesthesia. Assumptio ns regarding risks in primiparous labour progress for term breech labo ur may need to be reevaluated. The data presented are suitable for com parison with those from other centres and for meta-analyses.