VAGINAL BREECH DELIVERY

STILL A SAFE MODE OF DELIVERY TO REDUCE THE RATE OF CESAREAN SECTION

Abstract

Objective: To determine the obstetric and perinatal outcome of pregnancies
with singleton breech presentation, and to scrutinize the causes of increasing incidence of
cesarean section in breech presentation. Design: Analytical Observational study. Place and
duration: Department of obstetrics and gynecology Fatima hospital Baqai university campus
from Jan 2010 to Oct 2011. Patients & Methods: This study includes 135 patients with singleton
breech presentation ≥ 34 weeks of gestation, were analyzed in detail with help of designed
performa. Patients were categorized in three groups. Groups a, who had elective C-section,
group b. who underwent emergency caesarean section or had C-section after failed trial of
vaginal delivery and group c. who had vaginal breech delivery. Elective caesarean section was
done in those cases that had some other indications for carrying out this procedure apart from
breech presentation. Trial of vaginal breech delivery was planned for all multiparous women
except those falling in group A. All antepartum fetal demise, twin pregnancies and placenta
previa of major degree were excluded. Results: Of 135 women, 7(5%) underwent prelabour
cesarean, and 128(95%), had trial of vaginal delivery, of whom 117(91.5%) delivered vaginally.
Significantly more infants weighing> 3.5kg were selected for prelabour and intrapartum
cesarean than vaginal delivery. Two neonates had Apgar score< 7 at 5 minutes but both were
normal neurologically. There were no nonanomalous perinatal death and no case of significant
trauma or neurological dysfunction. Two infants died due to lethal anomalies. Conclusion:
Trial of vaginal breech delivery in well counselled patients, still taken as an appropriate option
without compromising prenatal and maternal outcome. It also decreases the rate of cesarean
section.