Undiagnosed breech revisited.
OBJECTIVE
To study the incidence of undiagnosed breech and to compare the obstetric outcome with those diagnosed before the onset of labour in a local teaching hospital where external cephalic version at term is routinely offered.


METHODS
A retrospective casenote analysis.


METHODS
Tsan Yuk Hospital, a teaching hospital in Hong Kong.


METHODS
One hundred and thirty-one women with a singleton breech presentation at term, delivered in a local teaching hospital from 1 January 1997 to 31 December 1997. The group of 22 women who had successful external cephalic version performed was included.


RESULTS
Breech presentation was diagnosed at the antenatal clinic in 103 women (79%). In the remaining 28 women (21%), breech presentation was diagnosed for the first time after the onset of labour. Undiagnosed breech presentations were more likely to deliver vaginally (42%) than those diagnosed at the antenatal clinic (11%) (P < 0.001). Vaginal delivery was still more common in the undiagnosed group (46%) than the diagnosed group (26%), even when the group with successful external cephalic version was included (P < 0.05), although the difference became less obvious. The demographic characteristics, birthweight, type of breech and short term neonatal outcomes were comparable between the two groups.


CONCLUSIONS
It is important to include women who had successful external cephalic version when comparing the obstetric outcome of undiagnosed and diagnosed breeches. Careful assessment for vaginal delivery is still very useful even when breech presentations are first diagnosed after the onset of labour because the infants are even more likely to deliver vaginally with no great excess of neonatal morbidity.
Leung
W C
WC
Department of Obstetrics and Gynaecology, The University of Hong Kong, Tsan Yuk Hospital, Hong Kong.
Pun
T C
TC
Wong
W M
WM
D000328:Adult; D001724:Birth Weight; D001946:Breech Presentation; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D011296:Prenatal Diagnosis / Q000379:methods*; D012189:Retrospective Studies