Outcome of 1040 consecutive breech deliveries: clinical experience of a maternity hospital in Turkey.
OBJECTIVE
To determine the optimal route of delivery in breech presentation.


METHODS
One-thousand and forty singleton breech deliveries among a total of 41785 deliveries that occurred at Zubeyde Hanim Maternity Hospital between 1990 and 1994 were analyzed.


RESULTS
The breech deliveries accounted for 2.4% of all deliveries. Of the patients, 572 (56.3%) were delivered vaginally and 468 (43.7%) were delivered by cesarean section. The mean ages of vaginal and cesarean delivery groups were 25.2 and 24.6 years, respectively. Forty-one (3.9%) of the fetuses had congenital anomaly. The leading congenital anomalies were meningocele in seven and hydrocephalus in six patients. Mullerian anomalies were encountered in 29 (6.1%) patients at cesarean section. Fetal morbidity observed in cesarean deliveries were fracture of the humerus in one and fracture of the femur in one and soft tissue injury in four cases. Fracture of the humerus was observed in two, Erb's paralysis in four, facial paralysis in one and soft tissue injury in 43 fetuses delivered vaginally. The leading causes of puerperal maternal morbidity were genital tract lacerations in vaginal delivery group and wound infection in cesarean delivery group. The overall perinatal mortality of this series was 54.8/1000 (57/1040). The corrected figures for cesarean delivery and vaginal delivery groups were 8.5/1000 (4/467) and 57.9/1000 (32/552), respectively.


CONCLUSIONS
We favor a selective approach for mode of delivery in patients with breech presentation in order to balance the fetal morbidity associated with vaginal delivery and maternal morbidity and cost associated with cesarean delivery.
Erkaya
S
S
Department of Obstetrics, Zübeyde Hanim Maternity Hospital, Altindağ, Turkey.
Tuncer
R A
RA
Kutlar
I
I
Onat
N
N
Erçakmak
S
S
D001720:Birth Injuries / Q000209:etiology; D001946:Breech Presentation; D002585:Cesarean Section / Q000009:adverse effects / Q000706:statistics & numerical data; D000013:Congenital Abnormalities / Q000453:epidemiology; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D016896:Treatment Outcome; D014421:Turkey