Correlation of perinatal outcome with mode of delivery for singleton breech presentation
International Journal of Clinical Obstetrics and Gynaecology
The intense obstetric controversy that breech presentation has generated still continues. Vaginal delivery of the breech was the norm until the late 1950s, when caesarean section was first recommended on the routine basis. A steadily increasing number of obstetricians are following the advice of Wright who proposed in 1959 that all breech presentation should be delivered by caesarean section. The recent publication of the Term Breech Trial by Hannah et al. (2000) is likely to place planned
... place planned vaginal breech delivery in the pages of history in the developed world. In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labour, planned vaginal delivery of singleton fetus in breech presentation at term remains a safe option that can be offered. Aim 1. To determine the perinatal outcome of singleton breech presentation of different gestational age in relation to the mode of delivery. 2. To study the factors favouring the vaginal breech delivery. 3. To correlate perinatal outcome with gestational age, birth weight, APGAR score in neonates delivered by vaginal delivery. 4. To study the factors associated with breech presentation. Materials & Methods: This study was conducted at a Hospital, Chennai, from Aug 20017 to July 2018. 220 cases of singleton breech presentation confirmed by clinical examination and ultrasound were selected for this study. Results 1. Incidence of breech presentation in Institute during my study was 2.59%. 2. The incidence of vaginal breech delivery was 26.1%. Conclusion 1. When strict selection criteria like multigravida, frank breech presentation, term gestation, estimated foetal weight more than or equal to 2 kg to 3 kg are met, planned vaginal delivery of singleton breech presentation remains a safe option that can be offered. 2. In preterm breech with 35-37 weeks gestation, caesarean section offers a better perinatal outcome.