The term breech presentation. A retrospective study with regard to the planned mode of delivery.
BACKGROUND
To analyze retrospectively a large group of term breech and vertex deliveries, with regard to the influence of the mode of delivery on the frequency of fetal and maternal complications.


METHODS
All singleton breech deliveries after completed 36 weeks of pregnancy, with a live fetus, delivered at Rogaland Central Hospital, from September 1 1996 to the May 10 2001 were included (n = 575). Correspondingly as a control group, 582 cases in vertex presentation were analyzed.


RESULTS
Planned vaginal delivery (VD) for the fetus in breech presentation (n = 448) in comparison with elective caesarean section (CS) (n = 127) increased early neonatal morbidity (3.6% vs. 0%). The frequency of Apgar scores < 7 at 5 min also increased (4.2% vs. 0.8%), as well as umbilical artery pH < 7.0 (4.4% vs. 0%), and referrals to the neonatal intensive care unit (NICU) (15.8% vs. 6.3%). Corresponding figures for planned VD of the fetus in vertex presentation were: 0.5% neonatal morbidity, 0.2% Apgar scores < 7 at 5 min, 8.1% admissions to NICU and 1.5% pH < 7.0 in umbilical arteries. Results comparing maternal morbidity in the different breech groups were inconclusive, but there were more maternal complications in the breech group planned for VD than in the corresponding vertex group (5.1% vs. 1.9%).


CONCLUSIONS
Elective CS for breech presentation will significantly decrease the risks for the fetus in comparison with planned VD.
Belfrage
Patrick
P
Department of Obstetrics and Gynecology, Rogaland Central Hospital, Stavanger, Norway. belfrage@online.no
Gjessing
Leif
L
D000328:Adult; D001946:Breech Presentation; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies