Breech presentation – an analysis of resultsin one perinatal center

Česká verze

Authors: J. Siváková ¹; K. Biringer ¹; M. Hrtánková ¹; P. Šumichrastová ¹; E. Kúdela ¹; Š. Sivák ²; I. Švecová ¹; J. Danko ¹
Authors place of work: Gynekologicko-pôrodnícka klinika, Jesseniova lekárska fakulta UK, Univerzitná nemocnica, Martin, Slovensko, prednosta prof. MUDr. J. Danko, CSc. ¹; Neurologická klinika, Jesseniova lekárska fakulta UK, Univerzitná nemocnica, Martin, Slovensko ²
Published in the journal: Ceska Gynekol 2014; 79(2): 107-114

Summary

Objective:
A retrospective analysis of medical records during years 2007–2011 considers maternal and fetal outcome in patients with breech presentation terminated by vaginal delivery versus caesarean section (CS).

Design:
Retrospective analysis.

Setting:
Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic.

Methods:
Authors devided patients with breech presentation of fetus (n = 299) to groups of single pregnancies terminated in term (n = 197), before term (n = 67) and to group of multiple pregnancies (n = 35). All groups were devided according to the way of termination of pregnancy by vaginal delivery, by acute CS and by planned CS. Main followed parameters: parity, gestational week, Apgar score, birth weight, birth length, fetal gender, indications for CS, mortality and neonatal morbidity, umbilical artery pH, convulsions, admit to neonatal intensive care unit, intubation of neonate, intracranial bleeding, cervical spine and peripheral nerve injuries.

Results:
Total cohort of breech deliveries was 299. In the group of single pregnancies in term was 19.8% terminated by vaginal delivery (n = 39), 32.5% deliveries by acute CS (n = 64). The most common indication was fetal hypoxia (43.8%). By planned CS was terminated 47.7% deliveries (n = 94). The most common indication for CS was footling presentation (54.3%). Severe neonatal morbidity was rare and without significant difference according to the type of termination of pregnancy. Neonatal outcome was comparable in the group of preterm deliveries(n = 67) terminated by vaginal delivery or by CS. All neonatal deaths were associated with extreme prematurity and not with type of termination of gravidity.

Conclusion:
Clinical outcomes between vaginal breech deliveries and breech deliveries terminated by CS in term in singleton pregnancies were not significant different. Mortality of neonates delivered by preterm delivery was associated with severe prematurity.

Keywords:
breech delivery, vaginal delivery, caesarean section, injury

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