There has been a decrease in the incidence of obstetric traumas in single newborn in vertex presentation weighing more than 2.499 g between 1983 and 1992, in Hessian hospitals, the drop in incidence being from 0.70 % to 0.33 %. The rate of injuries depends on the birth weight. During the perinatal analysis period of 10 years the average rate of injuries is 0.47 % in the birth weight range between 2.500-3.999 g, in the range between 4.000 and 4.499 g 1.61 % and in the birth weight group above 4.499 g 3.39 %. These differences are statistically highly significant. During the ten years under report, 1.908 infant injuries at birth were recorded. 70 % of these infants were in the 2.500-3.999 g range and only 6.7 % in the weight group beyond 4.999 g. There are no comparable data in literature. The drop in the rate of injuries compared to 1983 is represented by a factor of 2.5 in the 2.500-3.999 g birth weight range, by 1.5 in the 4.000-4.499 g range and by 1.8 in the group over 4.999 g. We do not intend to artificially construct a connection, but during the report period there was an increase in the rate of Caesarean sections in cases of vertex presentation and single births, in all weight groups. If in any particular case the birth weight is estimated to be higher than 4.499 g according to sonographic examination, this does not imply that Caesarean section must be performed, since that would be associated with increased maternal morbidity. Birth traumas can be reduced only if the acute situation of a shoulder dystocia can be simulated in training programmes so that the obstetrician is continually confronted with the relevant obstetric operations for acquiring the necessary practical skill.
