Cesarean section. Risk and benefits for mother and fetus
B. P. Sachs, B. J. McCarthy, G. Rubin, A. Burton, J. Terry and C. W. Tyler Jr
We studied the effects of cesarean section on neonatal mortality for breech
infants and low--birth weight vertex infants using data from the Georgia
neonatal surveillance network on 392,241 singleton deliveries between 1974
and 1978. The risk of neonatal death for breech infants weighing 4,000 g or
less delivered vaginally was significantly higher than the risk for those
delivered by cesarean section. The lower the birth weight, the higher the
risk for a vaginal breech delivery. For breech infants weighing 1,000 to
2,500 g, the risk was almost 21/2 times greater for a vaginal delivery v a
cesarean delivery. The best outcome for high-risk vertex infants weighing
1,000 to 1,500 g was for those delivered by cesarean section in a tertiary
perinatal center. An increase in the cesarean section rate may be
associated with increased neonatal survival; however, the benefits must be
weighed against the costs of an increased maternal mortality and morbidity.
