Forløsning ved underkropspræsentation til termin: En registerbaseret undersøgelse

The object of the study was to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other. Information on all (n=15,718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990 was obtained from the Medical Birth Register. A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency caesarean section. Infants delivered vaginally and by emergency caesarean section had significantly higher rates of mortality (intra-partum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective caesarean section. In vaginal deliveries, parity was not correlated with out-come, but infants with a birth weight above 4000 grammes had significantly higher rates of low Apgar scores. Conclusion: Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by caesarean section.