[Progress of labor and neonatal morbidity in primiparity with breech presentation].
Progress of labour in 100 consecutively delivered term ( > or = 37 weeks) primiparous breech births was analysed and correlated with fetal outcome according to different durations of first and second stages. All women had sonographic biometry prior to admission and epidural anaesthesia (PDA) early in established labour. Women with nonreassuring fetal heart rate tracings during any stage of labour were delivered by caesarean section, and were excluded. Birth weights were between 1980 g and 4090 g. There was no perinatal mortality, but eight neonates sustained birth associated trauma (6 Erb's palsies, two fractured long bones), all of which regressed spontaneously. Risk of neonatal trauma and of reduced Apgar scores was significantly associated with duration of the first stage but not of the second stage. It appears that short first stage duration (i.e. up to six hours) or a cervical dilatation rate 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 duration associated with low trauma risk could be seen in this group of parturients with effective continuous epidural anaesthesia. Assumptions regarding risks in primiparous labour progress for term breech labour may need to be reevaluated. The data presented are suitable for comparison with those from other centres and for metaanalyses.
Perl
F M
FM
St. Elisabeth-Krankenhaus Hohenlind, Akadem, Lehrkrankenhaus, Universität zu Köln.
Friederichs-Vieten
W
W
Klöck
F K
FK
D000328:Adult; D001034:Apgar Score; D001720:Birth Injuries / Q000209:etiology* / Q000517:prevention & control; D001724:Birth Weight; D001946:Breech Presentation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007747:Labor Stage, First; D007748:Labor Stage, Second; D007744:Obstetric Labor Complications / Q000209:etiology* / Q000628:therapy; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
Der Geburtsverlauf und die neonatale Morbidität bei Erstgebärenden mit Beckenendlage.