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

Chaudary, Rajendra Kumar; Ghimire, Rajan; Kafle, Deepak Raj

doi:10.31729/jnma.3697

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…The higher rates of perinatal morbidity and mortality associated with vaginal breech deliveries in our study are not in compliance with results from other hospitals of Nepal [ 11 – 13 ]. This may be because of insufficient sample size in study—that those hospitals have lower numbers of total deliveries which allows them to allocate adequate human resources for the management of those cases.…”

Section: Discussioncontrasting

confidence: 85%

“…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 ].…”

Section: Discussionmentioning

confidence: 99%

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

Basnet

Thapa

Das

et al. 2020

Obstetrics and Gynecology International

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Background. Breech presentation is associated with increased rates of maternal and perinatal morbidity regardless of mode of delivery. After the results of Term Breech Trial, most of the countries adopted the protocol of cesarean section for term breech delivery because of which breech vaginal delivery is becoming rare. The aim of this study is to evaluate short-term maternal and perinatal outcomes of breech vaginal delivery at a tertiary care hospital in Nepal. Methods. A retrospective review of case records of all women who had vaginal breech delivery from April 13, 2016, to April 12, 2018, was conducted, over a period of two years. Available demographic variables, obstetric characteristics, details of labor, postpartum complications, and perinatal complications were recorded and analyzed. Results. Out of 21,768 cases of deliveries during the study period, the incidence of term breech deliveries was 528 (2.4%) among which the mode of only 84 (17.8%) deliveries was vaginal. Most of the deliveries were unplanned and were conducted because emergency cesarean section could not be performed. Three (3.6%) women had postpartum hemorrhage, and four (4.8%) had entrapment of aftercoming head, two of them requiring Dührssen incisions. Adverse perinatal outcomes were seen in 23.8% of such deliveries with <7 APGAR score at 5 minutes in 20.2%, neonatal admission in 17.7%, and perinatal mortality in 8.3%. The perinatal mortality was significantly associated with birthweight less than 2500 grams as compared to birthweight ≥2500 grams (21.1% versus 4.6%; P = 0.043 ). Conclusion. The perinatal outcomes for vaginal breech delivery are grave with our existing health facilities, especially when the deliveries are not well planned.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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

Basnet

Thapa

Das

et al. 2020

Obstetrics and Gynecology International

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“…Similarly, Apgar scores and weight at birth of neonates who were delivered by LSCS were comparatively better than those delivered vaginally. (Table 3) Similar results were demonstrated by previous studies conducted in Nepal 10,20 and India. 7 .…”

Section: Discussionsupporting

confidence: 90%

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

Tamrakar¹,

Sitaula

Sharma³

et al. 2021

JCMC

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Background: Breech presentation has been associated with higher rates of perinatal morbidity irrespective of mode of delivery. The aim of this study was to determine the prevalence and perinatal outcomes of singleton breech deliveries at Chitwan Medical College, a tertiary level hospital in Nepal. Methods: A retrospective review of records of all women who delivered at Chitwan Medical College with breech presentation from September 2018 to October 2020 was conducted. Information on demographic variables, obstetric characteristics and perinatal outcomes were obtained, recorded and analyzed. Results: Out of 6712 cases of deliveries during the study period, 226 had breech presentation with prevalence of 3.37%. One hundred ninety-one (84.5%) of them had undergone Caesarean delivery with 125 (65.4%) emergency and 66 (34.6%) elective Caesarean delivery. More than two third (70.4%) of breech deliveries were term deliveries while 28.8% were preterm. There were 2 cases of still births and 1 neonatal death with Perinatal Mortality Rate of 13.27 per 1000 breech deliveries. Vaginal breech delivery was associated with higher perinatal mortality, low Apgar score and low birth weight. Caesarean breech delivery was associated with increased rates of Neonatal Intensive Care Unit admission. Conclusions: The neonatal mortality and morbidity were higher with the vaginal breech deliveries. However further studies with larger sample size and greater statistical power is necessary to draw definitive conclusion.

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“…10 Similarly, Choudhary et al reported maximum breech (70.6%) in age-group 20-30 years. 11 In the present study, approximately 64.4% were primigravida and 35.6% were multigravida. In similar studies, Panda et al, Kavita et al and Sonali et al, reported 52%, 62% and 53% primigravida.…”

Section: Discussionsupporting

confidence: 43%

A study of perinatal outcome in patients with breech presentation at tertiary care centre

Jadhav,

Yadav,

Kumar

2023

Int J Reprod Contracept Obstet Gynecol

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Background: Regardless of the delivery method, breech presentation causes a 2–4 times increase in perinatal death and morbidity. Any change toward the method or technique of breech birth should attempt to enhance the perinatal result as well as maintain low rates of maternal morbidity and mortality. The success of a particular strategy for the management of labour with breech presentation is determined by the fetal outcome. Methods: This prospective observational study was conducted in 320 consecutive patients with breech presentation at tertiary care centre from 1 January 2021 to 31 August 2022. This study was approved from Institutional ethical committee. Results: In 206 primi gravida females, 4 underwent vaginal breech delivery and 202 had LSCS. Among 114 multigravida females, 66 had LSCS and 48 had vaginal breech delivery. Majority (213 cases, 66.6%) were term deliveries and 33.4% (107 cases) had preterm deliveries. 83.38% (268 cases) had LSCS and 16.3% (52 cases) had vaginal delivery. Of all vaginal deliveries 46 were assisted vaginal deliveries and 6 were spontaneous vaginal delivery. It was found that out of all 52 vaginal deliveries, 15 (28.8%) patients had complications. And out of all 268 LSCS, 32 (11.9%) patients had complications. Maternal complications were found to be statistically significant associated with vaginal breech delivery (p=0.02*). Total 5 perinatal mortalities were observed with emergency LSCS and no perinatal mortality was found with elective LSCS. Conclusions: Multiparous women has better maternal and perinatal outcome compared to Primigravida with breech presentation. Zero perinatal mortality in elective caesarean section. Perinatal outcome is good in elective LSCS than in an emergency LSCS.

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

Cited by 4 publications

References 7 publications

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

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

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

A study of perinatal outcome in patients with breech presentation at tertiary care centre

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