Mode of delivery for breech presentation in grandmultiparous women

Abstract

In breech presentations at term vaginal delivery can be achieved in 85% of grandmultiparas without significant neonatal morbidity. Elective cesarean section is associated with increased maternal morbidity compared with planned vaginal delivery.

Outcome of Breech Deliveries in Cameroonian Nulliparous Women

“…Similar results have been reported by other authors [10][11][12]. The rate observed in this study is higher than the rates observed in the other series [8]. Safe VBD is possible among nullipara if certain criteria are met.…”

“…Such an approach could not become universally acceptable because the cost of cesarean section in developing countries is not affordable by all pregnant women. Moreover, cesarean section is associated with a non-negligible maternal morbidity [7,8]. For these reasons, therefore, trial of vaginal delivery (VD) could be offered in some nulliparous women with fetus in breech presentation.…”

Breech presentation at a district level hospital in South Africa

“…If, however, the woman and her partner wish to have a larger family, then the threshold for c/s might change the advice offered. 22 Furthermore, if the woman is a primigravidae the chances of her having a c/s if she has a breech presentation is so high that she may opt for c/s. Would a pragmatic approach to the mode of breech presentation be suitable for under-resourced countries?…”

Breech Presentation Among Nullipara at Term: An Indication for Caesarean Section

“…4 Different studies have shown the probability of emergency caesarean among patients with attempted vaginal delivery at term varied from 17.4 to 51%.3 Further ladies undergoing emergency caesarean section for breech were mostly nullipara and also neonates delivered through emergency section had increased complications. 5 Thus it is evident that nullipara ladies with breech presentation had maternal/neonatal complications and increased operative interference when vaginal delivery was attempted. Hence this study aims to justify the mode of delivery for nullipara with breech and also to highlight the cause of breech.…”

“…Regarding Multiparity and vaginal breech delivery, multipara ladies are more likely to deliver vaginally than nulliparous and had no complications. 5 Gilbert WM et al also reported high neonatal death rate among nullipara ladies following vaginal breech delivery. 16 The dilemma here is about mode of delivery nullipara rather than multipara.…”