Breech delivery in twenty years of practice.
A major area of controversy and concern in current obstetrics practice is the management of breech presentation. Studies showing a threefold to fourfold increased morbidity rate in breeches delivered vaginally have led to striking increases in cesarean section rates. The present study comprises a review of all breech deliveries in a partnership practice through the years 1957 to 1976 to permit a follow-up period of at least 2 years. One hundred forty-one breech presentations (excluding twin pregnancies) from a total of 5,320 viable deliveries (2.6%) were managed by one of four obstetrician-gynecologists. Follow-up of the child for a period varying from 2 to 21 years was achieved in over 60% of cases. Results tend to confirm the increased hazard of vaginal delivery to the premature infant in a breech presentation but are equivocal in infants whose birth weight is greater than 2,500 gm. Implications of the study are discussed and comparison with a similar study, presented before this Society more than 25 years ago, is made.
D000293:Adolescent; D000328:Adult; D001946:Breech Presentation; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology; D007746:Labor Presentation; D008423:Maternal Age; D007744:Obstetric Labor Complications; D009772:Obstetrical Forceps; D010043:Outcome and Process Assessment, Health Care; D010298:Parity; D011247:Pregnancy; D012306:Risk