| Abstract (croatian) | Cilj rada. Utvrditi postojanje razlika u ranom neonatalnom ishodu novorođenčadi vezano uz način dovršenja trudnoće. Ispitanice i metode. Ispitivanu skupinu sačinjavalo je 998 rodilja/trudnica koje su u Klinici za ginekologiju i porodništvo KBC-a Rijeka rodile u stavu zatkom u razdoblju od 1.siječnja 2000. do 31. prosinca 2010. godine. Iz ispitivanja su isključene sve višeplodove trudnoće, svi porodi prije navršenog 37. tjedna trudnoće i svi slučajevi kasne fetalne smrti, a rodilje bile su prema načinu dovršenja trudnoće podijeljene u tri skupine: vaginalni porod, elektivni carski rez i hitni carski rez. Rezultati. Niskom Apgar ocjenom (API<7) češće su ocijenjena novorođenčad nakon vaginalnih poroda (3%), a u toj ispitivanoj skupini zabilježene su i dvije porodne ozljede (0,3%). U istoj skupini češće je provedena reanimacija (3%), češće je bila potrebna mehanička ventilacija (1,3%) i novorođenčad su češće imala neurološku simptomatologiju (2,2%). Sva novorođenčad u koje su provedene metode reanimacije liječena su u JILN-u. Nije bilo neonatalnog mortaliteta ni u jednoj od ispitivanih skupina. Zaključak. Razlike u perinatalnom ishodu novorođenčadi nisu bile statistički znakovite, premda su najbolji perinatalni ishod imala novorođenčad iz skupine poroda dovršenih elektivnim carskim rezom. |
| Abstract (english) | A breech presentation is a presentation abnormality, in which the breech of the fetus in a longitudinal lie is the presenting part in the birth canal, whereas its head is situated in the fundus of the uterus. In 3–4% of all single pregnancies the fetus will be in breech presentation at term. Objectives. This clinical research was conducted in order to establish the existence of differences in early neonatal outcomes in newborns. Patients and methods. A total of 998 parturient/pregnant women were monitored and gave birth of the fetus in breech presentation during the mentioned clinical research at the Clinic for Gynaecology and Obstetrics of the Clinical Hospital Centre in Rijeka, between January 1, 2000 and December 31, 2010. In order to achieve the consistency of data and results as well as the objectivity of clinical deductions, all the multiple pregnancies, all the deliveries before the 37 weeks gestation and all the late fetal deaths were excluded from the research. All parturient/pregnant women were, based on the mode of delivery, divided into three groups (vaginal birth, elective caesarean section, and urgent caesarean section). The evaluation of perinatal outcome was based on the analysis of the fetal sex, its weight, length and head circumference, Apgar score at 5 minutes after birth, admission to and length of stay in the intensive care unit, and early neonatal morbidity. All data for each of three groups were compared and statistically analyzed by the statistic data processing program Statistica 7.1 (Stat.Soft.Inc.) Results. From altogether 998 breech deliveries 595 (59,6%) were assigned to vaginal birth, 296 (29,7%) were assigned to urgent caesarean section and 107 (10.7%) to elective caesarean section. Within the selected group of 998 single pregnancies the frequency of vaginal birth was rising during eleven years of research and reached its peak in the year 2007 (74,2%). The age and the parity of women had no influence on the choice of delivery mode. Regardless the mode of delivery in cases of breech presentation – vaginal birth, urgent or elective caesarean section birth, no statistically significant differences were established regarding the perinatal outcome and early neonatal morbidity (birth trauma, frequency of reanimation procedures, neurological damages, and duration of stay in the NICU). Conclusions. No significant differences were shown in the early neonatal outcome, although newborns after elective caesarean section had best neonatal outcome. During the observation period appeared no cases of neonatal or maternal mortality in any of three analysed groups of pregnancies/deliveries |
