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.
Hellsten
Charlotte
C
Department of Obstetrics and Gynecology, Malmö University Hospital, Lund University, Malmö S-205 02, Sweden.
Lindqvist
Pelle G
PG
Olofsson
Per
P
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