Lageanomalien und Geminischwangerschaft - Handling und Outcome von Risikogeburten am Orotta Hospital in Asmara / Eritrea

The aim of this study was to estimate the outcome of singleton- and twin pregnancies in both breech and cephalic presentation. Furthermore it was necessary to clarify which alterations to the pre- and perinatal management could improve the outcome. We collected prospective data of 813 deliveries from February to April 2007. Furthermore retrospective data of 1200 deliveries were collected. This took place in Orotta Hospital in Asmara / Eritrea. Both anamnesis and delivery data was evaluated. Breech presentation: 64 (3,6%) of 1772 singletons were in breech presentation. A child in breech presentation has, in comparison to a child in cephalic presentation, a 5,6- times (OR) higher risk to receive a 5-minute-APGAR score of <8 and a 13- times (OR) higher risk to receive a 10-minute-APGAR score of <8. Transverse lie: 9 (0,5%) patients had a child with transverse lie. A child in transverse lie has, in comparison to a child in cephalic presentation, a 7- times (OR) higher risk of receiving a 5-minute-APGAR score of <8 and a 4-times (OR) higher risk of receiving a 10-minute-APGAR score of <8. Twins: There have been 33 twin pregnancies, 18 times (55%) with fetus 1/ fetus 2 in cephalic/cephalic presentations, 7 times (21%) cephalic/breech presentations, 4 times (12%) breech/cephalic presentations, 3 times (9%) breech/breech presentations and one time (3%) breech/transverse lie. The difference between singleton and twin 5-minute-APGAR and 10-minute- APGAR values was statistically significant. It was clearly recognizable that the singleton APGAR values where better than the APGAR values of twins. If there were experienced academic personal present, the morbidity and mortality rate could be reduced. Regularly pre-examinations and examinations with medical equipment could help to make a diagnosis and, as a consequence, affect the outcome positively.