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External Cephalic Version: Is it an Effective and Safe Procedure?
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Breech presentation among nullipara at term: an indication for caesarean section.

A Dongol1, S Regmi, S Manandhar

  • 1Department of Gynaecology and Obstretrics, Kathmandu University Medical School of Sciences, Kathmandu University Hospital, Dhulikhel Hospital, Dhulikhel, Kavre.

Kathmandu University Medical Journal (KUMJ)
|April 12, 2013
PubMed
Summary

Planned cesarean delivery is recommended for nulliparous women with breech presentation. This approach offers improved outcomes for both mother and baby, reducing risks associated with vaginal breech birth.

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Neonatal Care

Background:

  • Breech presentation is the most common fetal malpresentation.
  • Vaginal breech delivery in nulliparous women poses higher risks compared to multiparous women.
  • Suboptimal neonatal outcomes in vaginal breech births fuel debate on delivery mode.

Purpose of the Study:

  • To assess the outcomes of planned cesarean sections in nulliparous women presenting with breech presentation.
  • To evaluate maternal and neonatal morbidity and mortality associated with cesarean delivery for breech presentation in nulliparous women.

Main Methods:

  • A prospective analytical study was conducted from January 2008 to June 2012.
  • 102 nulliparous women at term gestation with breech presentation underwent cesarean section (elective or emergency).
  • Neonatal condition assessed via APGAR score, resuscitation needs, and NICU admission; maternal outcomes included postpartum status and morbidity.

Main Results:

  • The majority of neonates (95%) had uneventful perinatal outcomes.
  • Cesarean delivery resulted in 2% stillbirths and 3% NICU admissions.
  • Maternal complications included wound infection in 10.7% of cases, with 15.6% requiring extended hospital stays.

Conclusions:

  • Elective cesarean section is the preferred delivery method for nulliparous women with breech presentation.
  • This approach aims to mitigate risks associated with vaginal breech delivery in this population.
  • Further research may explore specific indications and optimize management strategies.