Comparison of vaginal and cesarean section delivery for fetuses in breech presentation

Abstract

The poor perinatal outcomes of breech delivered infants are due primarily to VLBW, congenital malformations, and premature labor. Although abdominal delivery had a lower NNM rate than vaginal delivery, the difference was not significant after adjustment for confounding factors. The results confirm the findings of a previously analyzed similar series delivered at our institution between 1980 and 1987. They suggest that, with appropriate technique, abdominal delivery is not mandatory in breech presentation.

Neonatal outcomes of preterm infants in breech presentation according to mode of birth in Canadian NICUs

“…Some investigators reported reduced mortality if delivery was by CS,1 3 9 23–27 whereas others have reported no difference in mortality 10 12 28 29. It is reasonable to speculate that preterm infants generally experience diminished stress and trauma during CS compared with labour and subsequent VB 26.…”

Good perinatal outcome in selective vaginal breech delivery at term

“…The management of term breech deliveries varies widely in obstetric units and has for decades been one of the most controversial issues in perinatology (1). Many reports suggest good results if vaginal breech delivery is allowed in selected cases, provided strict criteria are followed during labor (2)(3)(4)(5), but also unacceptable results have been achieved even after proper selection (6,7). There was a general demand for randomized and controlled studies until Hannah and colleagues conducted a large, randomized multicenter study, the Term Breech Trial (TBT), to determine whether planned cesarean section (CS) was better than planned vaginal birth for selected fetuses in the breech presentation at term (8).…”

Trial of Vaginal Breech Delivery: Current Role

“…However, when birth weight was controlled between the 2 groups, this difference failed to remain statistically significant. 23 In a retrospective study performed by Gorbe and colleagues, 24 1009 breech infants weighing less than 1500 g delivered vaginally over a 5-year period at a single institution were evaluated. These infants demonstrated an increased incidence of perinatal mortality compared with those delivered by cesarean.…”