title: [Preterm breech before 35 weeks of gestation: What is the influence of the delivery route on neonatal condition?].
abstract: OBJECTIVE
  The mode of delivery for preterm breech is still controversial, while no randomized study has been completed. The question of a protective effect of cesarean section on neonatal outcome arises. The objective of this study was to compare mortality and neonatal morbidity for children born before 35 weeks of gestation in breech presentation, depending on the route of delivery.
  
  
  METHODS
  This was a retrospective study done in University Hospital type 3 over five years, comparing neonatal mortality and different neonatal morbidity criteria for children born between 25 weeks of gestation and 34 weeks+6 days spread into two groups according to their mode of delivery: elective caesarean section before labor and vaginal delivery. Statistical analysis was performed with an adjustment for gestational age and weight of the newborn.
  
  
  RESULTS
  No significant difference between the two groups was found with regard to neonatal mortality. Among the various morbidity criteria studied, only the head entrapment rate and serious traumatic injury occurrence were significantly increased in the "intent to vaginal delivery" group. pH at birth and Apgar scores at five minutes were not significantly different between the two groups.
  
  
  CONCLUSIONS
  This work shows an increased risk of traumatic complications for vaginal delivery with no increase in other neonatal complications. It seems reasonable in this particular context to allow an attempt at vaginal delivery on condition of strict compliance with safety regulations relating to breech delivery.
authors.affiliation: Service et département de gynécologie-obstétrique et médecine de la reproduction, pôle Femme-Enfant, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France. Electronic address: noemiebruey@yahoo.fr.
authors.forename: N
authors.initials: N
authors.lastname: Bruey
authors.affiliation: Centre hospitalier Avranches-Granville, 59, rue de la Liberté, 50300 Avranches, France.
authors.forename: D
authors.initials: D
authors.lastname: Reinbold
authors.affiliation: Université de Caen Basse-Normandie, esplanade de la Paix, 14032 Caen cedex 5, France; Unité de biostatistique et de recherche clinique, hôpital Clémenceau, CHU de Caen, boulevard Clémenceau, 14033 Caen cedex 9, France.
authors.forename: C
authors.initials: C
authors.lastname: Creveuil
authors.affiliation: Service et département de gynécologie-obstétrique et médecine de la reproduction, pôle Femme-Enfant, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France; Université de Caen Basse-Normandie, esplanade de la Paix, 14032 Caen cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
mesh_terms: D000328:Adult; D001720:Birth Injuries / Q000453:epidemiology; D001724:Birth Weight; D001946:Breech Presentation / Q000401:mortality; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D009017:Morbidity; D011247:Pregnancy; D011256:Pregnancy Outcome
keywords: Accouchement par voie basse; Breech; Cesarean section; Césarienne; Devenir néonatal; Neonatal outcome; Preterm; Prématuré; Siège; Vaginal delivery