Breech presentation: a retrospective analysis of 12-years' experience at a single center.
OBJECTIVE
To investigate neonatal outcome after breech presentation in term pregnancies.


METHODS
Data from 1345 term breech deliveries over a 12-year study period were retrospectively reviewed. Neonatal morbidity and mortality were compared by route of delivery.


RESULTS
We investigated 1345 term breech deliveries. A total of 1041 patients (77.4%) attempted a vaginal delivery; of these, 808 (60.1%) were delivered vaginally and 233 patients (17.3%) who failed at vaginal birth underwent cesarean section. The other 304 women (22.6%) were delivered by a planned cesarean section. No statistical differences were found in the incidence of low 5-minute Apgar scores and arterial cord blood pH values<or=7. Admission to neonatal units was higher after vaginal delivery than after elective cesarean section (55.0% vs. 20.0%). The difference between vaginal delivery and cesarean section in the rate of severe plexus injuries was statistically significant (P=0.0025). Two neonatal deaths occurred at term after a trial of labor. No perinatal death of a term breech infant occurred in the cesarean section group.


CONCLUSIONS
The increased risk of birth trauma and admission to a neonatal intensive care unit after vaginal delivery emphasizes the advantages of a planned cesarean section for a breech presentation.
Department of Obstetrics and Gynecology, Division of Obstetrics and Feto-maternal Medicine, University of Vienna Medical School, and Hospital Goettlicher Heiland, Vienna, Austria. mariella.mailath-pokorny@meduniwien.ac.at
Mariella
M
Mailàth-Pokorny
Oliver
O
Preyer
Christian
C
Dadak
Andreas
A
Lischka
Martina
M
Mittlböck
Peter
P
Wagenbichler
Thomas
T
Laml
D000293:Adolescent; D000328:Adult; D001317:Austria / Q000453:epidemiology; D001946:Breech Presentation / Q000401:mortality*; D036861:Delivery, Obstetric / Q000401:mortality*; D005260:Female; D006801:Humans; D015994:Incidence; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult