INCIDENCE OF PERINATAL BIRTH TRAUMAS DEPE NDING ON THE BIRTH-WEIGHT PERINATAL ANALYSIS CONDUCTED IN HESSEN

There has been a decrease in the incidence of obstetric traumas in sin gle newborn in vertex presentation weighing more than 2.499 g between 1983 and 1992, in Hessian hospitals, the drop in incidence being from 0.70 % to 0.33 %. The rate of injuries depends on the birth weight. Du ring the perinatal analysis period of 10 years the average rate of inj uries is 0.47 % in the birth weight range between 2.500-3.999 g, in th e range between 4.000 and 4.499 g 1.61 % and in the birth weight group above 4.499 g 3.39 %. These differences are statistically highly sign ificant. During the ten years under report, 1.908 infant injuries at b irth were recorded. 70 % of these infants were in the 2.500-3.999 g ra nge and only 6.7 % in the weight group beyond 4.999 g. There are no co mparable data in literature. The drop in the rate of injuries compared to 1983 is represented by a factor of 2.5 in the 2.500-3.999 g birth weight range, by 1.5 in the 4.000-4.499 g range and by 1.8 in the grou p over 4.999 g. We do not intend to artificially construct a connectio n, but during the report period there was an increase in the rate of C aesarean sections in cases of vertex presentation and single births, i n all weight groups. If in any particular case the birth weight is est imated to be higher than 4.499 g according to sonographic examination, this does not imply that Caesarean section must be performed, since t hat would be associated with increased maternal morbidity. Birth traum as can be reduced only if the acute situation of a shoulder dystocia c an be simulated in training programmes so that the obstetrician is con tinually confronted with the relevant obstetric operations for acquiri ng the necessary practical skill.