Comparison of Perinatal Outcome of Breech Presentation between Vaginal Delivery and Cesarean Section

Abstract

Introduction: Many times, parturient opt for labour and vaginal breech delivery even after informing increased perinatal risks. Vaginal breech deliveries are undertaken with the reasons like avoidance of cesarean section in next pregnancy, null risk of operative and anesthetic hazards, ability to resume early all household works after vaginal birth, etc. The purpose of this study is to compare the perinatal outcome of breech deliveries in singleton breech presentation between vaginal breech delivery and cesarean section.
 
 Methods: A retrospective study was done in Lumbini Medical College Teaching Hospital for the duration of one year (December 2014 to November 2015). Data of perinatal outcome of breech deliveries were collected from the hospital records. The records of neonatal examination were also collected. The primary outcomes included were neonatal morbidity and mortality.
 
 Results: Out of 80 selected women with breech presentation, 42 of them had vaginal deliveries and 38 women had undergone caesarean section. The perinatal mortality was 4.8% and morbidity was 2% in vaginal breech deliveries. There was no significant difference of APGAR score in the two groups at any time. Similarly, there was no significant difference in perinatal morbidity and mortality in the two groups. Nulliparous women were more likely to deliver by Cesarean section.
 
 Conclusion: In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labour, planned vaginal breech delivery of singleton fetus in breech presentation remains a safe option that can be offered to women.

Maternal and Perinatal Outcomes of Singleton Term Breech Vaginal Delivery at a Tertiary Care Center in Nepal: A Retrospective Analysis

“…Large population based studies are not available to quote the incidence of breech deliveries in our setup. Hospital-based studies conducted in different tertiary level hospitals have reported the breech delivery incidence of 1.9–2.5% [ 11 , 12 ], similar to the incidence reported in our study. But this is slightly lower than the overall incidence of 3–5% [ 1 ].…”

“…Our analysis reported a very high perinatal mortality among vaginal breech deliveries compared to other studies [ 11 , 12 , 15 ]. Mortalities were higher among those with gestation more than 40 weeks, or among babies weighing less than 2500 grams as compared to those with birthweight ≥2500 grams (21.05% versus 4.62%; P =0.043).…”

“…This led to many unplanned vaginal breech deliveries which in part is responsible for the high rate of adverse perinatal outcome. Nevertheless, the prevalence is not homogeneous all over the country; hospitals have reported up to 40–52% of vaginal deliveries among breech presentation with perinatal outcomes similar to or even superior to cesarean deliveries [ 12 , 13 ].…”

Perinatal Outcomes of Singleton Breech Deliveries in a Tertiary Care Centre in Nepal

“…This study was aimed at determining the prevalence and perinatal outcomes of singleton breech delivery at a tertiary level hospital in Nepal. The prevalence of breech presentation in our study was higher than that reported by previous studies conducted in Nepal (1.9-3.1%), 10,13,14 but it was less than the prevalence reported in Ethiopia 5 and Malaysia. 6 Our centre is a tertiary level hospital where significantly large number of cases of high-risk pregnancy including abnormal presentations are referred in, which might be the reason for higher incidence of breech in comparison to previous national studies.…”

Perinatal Outcome of Vaginal Breech Delivery versus Caesarean Breech Delivery in a Tertiary Care Center

“…Nulliparous women were more likely to deliver by cesarean section. 4 Another study in Patan Academy of Health Sciences concluded that in well-selected cases, the neonatal outcome following assisted vaginal breech delivery and caesarean section may not be different. 5 Adverse perinatal outcome in planned vaginal breech labor at term is associated with fetal growth restriction, oligohydramnios, previous cesarean delivery, gestational diabetes, nulliparity and epidural anesthesia.…”