BREECH BIRTH OUTCOMES - A TEN-YEAR PERIOD ANALYSIS AT CLINICAL HOSPITAL CENTER RIJEKA

Uvod: Stav ili prezentacija zatkom podrazumijeva nepravilnu prezentaciju u kojoj fetus zauzima uzdužni položaj, ali pritom je vodeća čest zadak, a glava se nalazi u fundusu maternice. Zbog dugačijeg mehanizma prolaska porodnim kanalom, češće se ovakve trudnoće dovršavaju carskim rezom. Cilj: Cilj istraživanja bio je utvrditi postoji li razlika u perinatalnim ishodima stava zatkom obzirom na način dovršenja trudnoće- vaginalni porod i carski rez. Ispitanici i postupci: Ispitivanu skupinu sačinjavalo je 1045 rodilja/trudnica koje su u Klinici za ginekologiju i porodništvo KBC-a Rijeka rodile novorođenčad u stavu zatkom u razdoblju od 1. siječnja 2010. do 31. prosinca 2019. godine. Iz istraživanja su isključene sve višeplodne trudnoće i svi slučajevi kasne fetalne smrti. Rezultati: Uočen je potpuni preokret u načinu dovršenja trudnoće u kojoj fetus zauzima stav zatkom. Posljednjih nekoliko godina dominantno se takve trudnoće dovršavaju carskim rezom. To se prema istraživanju u Riječkom rodilištu i nije pokazalo opravdanim, iz razloga što se nije pronašla statistički značajna razlika u perinatalnom ishodu novorođenčadi porođene vaginalnim putem, odnosno carskim rezom. Zaključak: Perinatalni ishodi novorođenčadi u stavu zatkom samo djelomično ovise o načinu dovršenja trudnoće. Puno je drugih faktora koji utječu na perinatalni ishod i iz tog je razloga od velike važnosti pravilna i pravodobna procjena porodničara te provođenje dobre kliničke prakse.Breech birth implies an incorrect presentation in which the fetus occupies a longitudinal position, but the leading one is often the buttocks, and the head is located in the fundus of the uterus. Due to the complicated mechanism of passage through the birth canal, such pregnancies are more often completed by caesarean section.The aim of the study was to determine whether there is a difference in the perinatal outcomes of the posture with regard to the manner of completion of pregnancy - vaginal delivery and cesarean section.The study group consisted of 1045 mothers/pregnant women who gave birth to newborns at the Clinical Hospital Center Rijeka in the period from 1 January 2010 to 31 December 2019. All multiple pregnancies and all cases of late fetal death were excluded from the study.A complete reversal was observed in the manner of completing the pregnancy in which the fetus takes a position with the buttocks. In recent years, such pregnancies have been predominantly completed by caesarean section. According to the research, this did not prove to be justified, due to the fact that no statistically significant difference was found in the perinatal outcome of newborns born vaginally, ie by caesarean section.The perinatal outcomes of breech birth neonates only partially depend on how the pregnancy is completed. There are many other factors that affect the perinatal outcome and for this reason it is of great importance for the obstetrician to properly and timely assess and implement good clinical practice