Vaginal breech delivery: is it still an option?
OBJECTIVE
To provide local data on term breech delivery for future guidance.


METHODS
Retrospective, 'intended-mode-of-delivery' analysis of 711 antenatally uncomplicated singleton breech deliveries at >or=37 weeks: 445 (63%) planned for vaginal delivery (VD) (no fetal growth restriction, fetal weight 2000-4000 g, adequate pelvic size, maternal consent) and 266 for cesarean section (CS).


METHODS
Apgar score, cord blood acid-base status, childhood deaths and disability.


RESULTS
Perinatal mortality was nil in both groups. Low 1-min Apgar scores and low arterial cord blood pH were significantly more frequent in planned VD, but not low Apgar scores at 5 or 10 min or low venous pH. Metabolic acidosis, neonatal intensive care, neonatal seizures, birth trauma, childhood death (CS=1), and neurodevelopmental handicaps (CS=2, VD=1) were equally common.


CONCLUSIONS
Our results do not disqualify selective vaginal breech delivery at term and beyond as an option.
Department of Obstetrics and Gynecology, Malmö University Hospital, Lund University, Malmö S-205 02, Sweden.
Charlotte
C
Hellsten
Pelle G
PG
Lindqvist
Per
P
Olofsson
D000328:Adult; D001034:Apgar Score; D001720:Birth Injuries / Q000453:epidemiology; D001946:Breech Presentation; D036861:Delivery, Obstetric / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D011247:Pregnancy