Pre-term delivery by Caesarean section 'en caul': A case series

Twenty-four pre-term infants (24-32 weeks) were delivered by Caesarean sect ion 'en caul', i.e. with the membranes left intact until the whole pregnanc y sac had been delivered. Seventeen survived to discharge from hospital (29 % mortality, 26% after exclusion of lethal congenital abnormality). Three b abies had a cord haemoglobin below 15 g/dl at delivery and 11 required bloo d transfusion. None had any other recognisable cause for the anaemia. Altho ugh en caul delivery has obvious theoretical advantages, the danger of caus ing fetal blood loss is real and should be evaluated in a randomised contro lled trial before widespread application. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.