Delivery in Breech Presentation: The Decision Making

Singh, Abha; Mishra, Nalini; Dewangan, R.

doi:10.1007/s13224-012-0289-7

Cited by 19 publications

(35 citation statements)

References 10 publications

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“…This is possibly because of the fact that in Indian women generally family life is completed by this age group due to early marriage and early age at first pregnancy (Table 2). 4,6 As evident from Table 3, present study correlates with previous studies by other authors, it favors incidence of extended (frank) breech more than complete breech with a rate of 68% and 32% respectively. [6][7][8][9] This is most probably because of a favorable engaging diameter in extended breech (bistrochanteric) and less space occupied by the narrow lower pole.…”

Section: Discussionsupporting

confidence: 91%

“…4,6 As evident from Table 3, present study correlates with previous studies by other authors, it favors incidence of extended (frank) breech more than complete breech with a rate of 68% and 32% respectively. [6][7][8][9] This is most probably because of a favorable engaging diameter in extended breech (bistrochanteric) and less space occupied by the narrow lower pole. A positive correlation was observed with previous studies by other authors, that in majority of the studies, caesarean section was more common as a mode of delivery than vaginal route, in breech presentation; but the incidence should not be that low as observed in a few studies depicted in Table 4.…”

Section: Discussionsupporting

confidence: 91%

“…6,8,17,18 According to the Table 6, compared to other series, present study has low perinatal mortality with breech presentation. This was attributed to the availability of qualified and proficient obstetricians round the clock to manage patients with malpresentations, as well as, the facility of intensive neonatal care available at our centre in the form of incubator, warmer, NICU and the presence of competent paediatricians in the labour room at the time of breech delivery.…”

Section: Discussionmentioning

confidence: 58%

“…This was attributed to the availability of qualified and proficient obstetricians round the clock to manage patients with malpresentations, as well as, the facility of intensive neonatal care available at our centre in the form of incubator, warmer, NICU and the presence of competent paediatricians in the labour room at the time of breech delivery. 4,6,9,[17][18][19] Chi-square value determined by epi-info software. Table 7 shows the probability of vaginal or caesarean delivery corresponding to the type of breech presentation.…”

Section: Discussionmentioning

confidence: 99%

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Fetomaternal outcome in breech delivery

Airao

Zala

Vasava

2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONBreech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. An attempt to reduce the fetal hazards inherent in a vaginal breech delivery has resulted in a high caesarean section rate which has approached 90-95% in some centers. Breech presentation is the 3 rd important indication which has led to higher caesarean section rates in recent times all over the world 1 . Although CS drastically reduces the perinatal mortality associated with breech delivery, it has not eliminated the associated fetal and maternal morbidity; in fact, it has been quoted that the competency of any obstetric unit is inversely proportional to the perinatal mortality of breech deliveries conducted in that unit. Therefore, any change or improvement in the mode or technique of breech delivery should aim at improving the perinatal outcome and also at keeping the maternal morbidity and mortality rates low. It is the fetus who suffers the most rather than the mother. So, the fetal outcome decides the merit of the particular method for the management of labour in breech ABSTRACTBackground: Breech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. The objectives of the present study are to know the common causes leading to breech presentation. Further, to compare the different management protocols and outcome in different types of breech presentation. Also, to know the perinatal morbidity and mortality associated with different types of breech presentation nd comparison of perinatal morbidity and mortality with vaginal delivery against cesarean section. Methods: This is a retrospective study of randomized 100 cases of pregnant women in labour with breech presentations after 28 weeks or more attending C U Shah Medical College, Surendranagar, over a period of May 2012 to April 2014. Results: Out of 100 patients breech presentation was more common in booked patients and multigravida. In primi and multigravidae patients, caesarean delivery was more compared to assisted breech delivery. Perinatal outcome was good in majority of the patients in both extended and complete breech with an incidence of 94% and 88% respectively. perinatal outcome was good in caesarean section with 100% compared to assisted breech delivery 93%. Conclusions:The balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation like ours. Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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Fetomaternal outcome in breech delivery

Airao

Zala

Vasava

2018

Int J Reprod Contracept Obstet Gynecol

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“…As shown in Figure 4, oligohydramnios and gestational hypertension were associated with breech in majority of cases undergoing caesarean section against study of Sonali et al, where post LSCS, bad obstetric history, gestational hypertension, oligos and fetal growth restriction were the indications for caesarean section. Table 3 shows that maternal morbidity was 10% in caesarean section against 3.4% in caesarean section and 4.2% in vaginal delivery in a study by Abha et al 3 From Table 4, term breech was seen in 88% of cases against 77.3% in the study by Abha Singh et al 3 56% had birth weight of 2.6-3kg and 14% had 3.1-3.5kg birth weight …”

Section: Resultsmentioning

confidence: 91%

Study of the obstetric outcome of breech presentation in pregnancy in a tertiary hospital in a rural area in Telangana, India

Kothapally

Uppu

Gillella

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONBreech is the common nonvertex presentation in 3-4% of pregnancies all over the world.1 Percentage of breech presentation and deliveries decreases with advancing gestational age, from 22% of births prior to 28 weeks to 7% of births at 32weeks to 1-3% of births at term. 1Incidence decreases towards term due to spontaneous version. So, an active process is involved in limiting this spontaneous version and it results in breech presentation. 2Breech presentation results from uterine anomalies, cornuofundal insertion of placenta, placenta previa, oligohydramnios, fetal getal growth restriction, prematurity, short umbilical cord, fetal anomalies like hydrocephalus, swellings in front of the neck.1 Hence, we should look for the presence of uterine anomalies, site of placenta and fetal anomalies in all cases of breech presentation. Perinatal mortality is increased 3-4fold with breech presentation irrespective of the mode of delivery. 1 Prematurity, cord prolapse and difficulties during vaginal breech delivery especially of the aftercoming head add to the increased perinatal mortality and morbidity following vaginal breech delivery.1 On the otherhand, through planned caesarean delivery, atleast at term, reduces the ABSTRACT Background: The present study was undertaken to study the incidence, aetiology and obstetric outcome of breech presentation in pregnancy in a teaching hospital in a rural area. Methods: The present retrospective observational study was conducted in the department of obstetrics and gynaecology at Bhaskar Medical College and Bhaskar General Hospital, Yenkepally, Telangana from May 2014 to March 2017. 50 cases of breech presentation were included in the study. Demographic data like age, parity, gestational age of first detection of breech, aetiological factors of breech, mode of delivery, neonatal outcome were noted from case records. Results: The incidence of breech was 1.4% in pregnancies attending Bhaskar general hospital. 74% were in the age group of 20-24yrs & 20% were in the age group of 25-29yrs. Primis accounted for 62% of the study group. Common etiologies of breech presentation were oligohydramnios (28%) and uterine anomalies (28%). No obvious fetal anomalies were noted. Majority (96%) of cases were delivered by caesarean section for breech associated with oligohydramnios, gestational hypertension, intrauterine fetal growth restriction and preterm. Neonatal outcome was good in breech delivered by caesarean section. Conclusions: Breech delivery is a high risk pregnancy with adverse fetal outcomes during pregnancy and labour. Though caesarean section for breech presentation is not universally recommended, caesarean section can reduce the perinatal mortality and morbidity compared to vaginal birth for term breech pregnancy. Mode of delivery should be decided based on the case and obstetrician's skill.

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