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Antenatal ultrasonography for breech delivery.
1Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra.
Summary
Prenatal sonography for breech presentation significantly improved neonatal outcomes. This imaging technique led to more planned cesarean sections and fewer traumatic deliveries, reducing birth asphyxia and perinatal mortality.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Diagnostic Imaging
Background:
- Breech presentation complicates approximately 3-5% of term deliveries.
- Management decisions for term breech presentation significantly impact maternal and neonatal outcomes.
- Sonography is a key tool in assessing fetal presentation and guiding delivery strategies.
Purpose of the Study:
- To evaluate the impact of pre-delivery sonography on the management and neonatal outcomes of term breech presentations.
- To compare outcomes between breech presentations managed with and without routine pre-delivery sonographic confirmation.
Main Methods:
- A comparative study involving 370 patients with breech presentation at or after 34 weeks gestation.
- Study group (185 cases) received sonographic confirmation of breech presentation prior to delivery.
- Control group (185 cases) did not have prior sonographic confirmation.
Main Results:
- The sonography group had significantly more elective cesarean sections compared to the control group.
- The control group experienced more emergency cesarean sections, traumatic deliveries, birth asphyxia, and perinatal mortality.
- Statistical significance was observed for cesarean section type (P=0.008) and adverse neonatal outcomes (P<0.05).
Conclusions:
- Pre-delivery sonography in term breech presentations (>= 34 weeks) is associated with improved neonatal outcomes.
- Routine sonographic assessment aids in optimizing delivery planning for breech presentations.
- Sonographic guidance can reduce adverse perinatal events in breech pregnancies.