Outcome of breech delivery at term.
OBJECTIVE
To compare neonatal mortality and morbidity in term infants presenting by the breech and delivered vaginally or by caesarean section.


METHODS
Population based comparison of outcomes. Data derived from the St Mary's maternity information system.


METHODS
North West Thames Regional Health Authority, 1988-90.


METHODS
3447 singleton fetuses presenting by the breech at term.


METHODS
Intrapartum and neonatal mortality, low Apgar scores, intubation at birth, and admission to special care baby units.


RESULTS
After the exclusion of babies with congenital anomalies the incidence of intrapartum and neonatal death associated with vaginal birth was 8/961 (0.83%) compared with 1/2486 (0.03%) in babies born by caesarean section (relative risk 20, 95% confidence interval 2.5 to 163). The numbers of low Apgar scores and neonatal intubation were doubled in babies born vaginally or by emergency caesarean section compared with those delivered by elective operation.


CONCLUSIONS
The good neonatal outcome associated with elective caesarean delivery of the term breech fetus may influence the decision of women and their obstetricians about mode of delivery.
Thorpe-Beeston
J G
JG
Department of Obstetrics, St Mary's Hospital, London.
Banfield
P J
PJ
Saunders
N J
NJ
D001034:Apgar Score; D001946:Breech Presentation; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007440:Intubation; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies