Cesarean section in breech by birth weight

Objective: To evaluate the effects of abdominal versus vaginal delivery in the groups of newborns with different birth weights. Methods: 5012 single breech deliveries with birth weight over 1000 g, lethal malformations and stillbirths excluded, were enrolled in the study. The comparison of early neonatal mortality and the incidence of 12 different symptoms and signs of fetal morbidity for abdominally/vaginally delivered newborns was made within four birth-weight groups. Results: In abdominal delivery we found statistically significantly lower neonatal mortality and incidence of low 5-min Apgar score in the 1000–1499-g birth-weight group; incidence of brachial plexus damage and hyperbilirubinemia due to blood resorption in the 2500–3799-g birth-weight group. In vaginal delivery we found statistically significantly lower incidence of low 1- and 5-min Apgar score, light and moderate hypoxia and RDS in the 1500–2499-g birth-weight group; low 1-min Apgar score and light hypoxia in the 2500–3799-g birth-weight group. Conclusion: The effects of abdominal delivery on newborn in breech are in many aspects poorer than in vaginal delivery. In our opinion the actual incidence (36%) of cesarean section could be decreased, especially in cases with expected birth weight over 1500 g.