Vaginal Vertex Delivery Research Articles

An analysis of the factors associated with respiratory distress syndrome in premature infants whose mothers had been given dexamethasone therapy.

The incidence of respiratory distress syndrome (RDS) in 259 premature infants whose 218 mothers had received antepartum dexamethasone therapy was 8.9 per cent. The main characteristics of those infants who developed RDS were a shorter gestational age and a lower Apgar score at delivery; all were delivered before 35 weeks gestation, and those with Apgar scores below 7 had a significantly higher incidence of RDS. The incidence of RDS in vaginal breech deliveries (15.4 per cent), Caesarean sections (14.6 per cent), and multiple births (16.0 per cent) was higher than in vaginal vertex deliveries (6.8 percent), and in singletons (6.0 per cent). The use of isoxsuprine and the length of time membranes were ruptured before delivery were unrelated to the incidence of RDS. The results of this study suggest that while maternal glucocorticoid administratioin is an important ancillary to the prevention of RDS in premature infants it cannot substitute for optimal delivery conditions.

Alterations in head shape of newborn infants after caesarean section or vaginal delivery.

Alterations of head shape in preterm, small-for-dates, and term normal infants were studied by measuring occipitofrontal circumference (OFC), biparietal diameter (BPD), and occipitofrontal diameter (OFD) at intervals after birth. In 9 preterm infants born by elective caesarean section ther was a 5-2% reduction in BPD and 2-0% reduction in OFC at the age of 7 days. In 18 term infants born by elective caesarean section these changes were 2-4% and 0% respectively in BPD and OFC. In 25 preterm infants born by vertex vaginal delivery there was a significant fall in OFC of 0-7% at the age of 7 days and of 2-4% in BPD, but no significant change in OFD. In 19 small-for-dates infants born vaginally OFC increased 1-0% and OFD 2-7% at 7 days, but BPD decreased 2-5%. After the first week all three measurements increased in both groups of vaginal deliveries. The results show that shrinkage and biparietal flattening of the skull occur during the first week of life in preterm and term infants born by caesarean section and in preterm infants born vaginally. This fact should be borne in mind when comparing the measurements of an infant's head size with published norms.