Early preterm breech delivery: is a policy of planned vaginal delivery associated with increased risk of neonatal death?
OBJECTIVE
The purpose of this study was to compare neonatal death rates in preterm singleton breech deliveries from 26 weeks to 29 weeks 6 days of gestation in centers with either a policy of planned vaginal delivery (PVD) or planned cesarean delivery (PCD).


METHODS
Women with preterm singleton breech deliveries were identified from the databases of 3 perinatal centers and classified as PVD or PCD according to the center's management policy.


RESULTS
The study included 84 women in the PVD group and 85 women in the PCD group. Incidence of neonatal death was similar in both (10.7% vs 7.1%; P = .40). Head entrapment (adjusted odds ratio, 7.2; 95% CI, 1.7-29.8), preterm premature rupture of membranes at <24 weeks of gestation (adjusted odds ratio, 13.3; 95% CI, 2.8-63.0), and gestational age between 26 weeks and 27 weeks 6 days of gestation (adjusted odds ratio, 4.7; 95% CI, 1.2-18.5) were associated independently with neonatal death.


CONCLUSIONS
Risk of neonatal death was not associated with any particular policy of mode of delivery.
Kayem
Gilles
G
Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, School of Medicine Paris XII, Créteil, Paris, France. gkayem@gmail.com
Baumann
Raphaël
R
Goffinet
François
F
El Abiad
Sawsan
S
Ville
Yves
Y
Cabrol
Dominique
D
Haddad
Bassam
B
D000328:Adult; D001946:Breech Presentation / Q000628:therapy*; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D012307:Risk Factors