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[Breech presentation deliveries].

L E Hvidman, K B Hansen, G M Eriksen

    Ugeskrift for Laeger
    |February 13, 1989
    PubMed
    Summary
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    Vaginal delivery of breech presentation infants is associated with increased low Apgar scores at one minute. However, long-term developmental outcomes and perinatal mortality rates were comparable to Caesarean sections, suggesting careful patient selection is key.

    Area of Science:

    • Obstetrics and Gynecology
    • Perinatal Medicine
    • Neonatal Outcomes

    Context:

    • Analysis of 5,519 term deliveries in the UK.
    • Evaluation of a protocol permitting vaginal breech delivery for estimated fetal weights between 2,400-3,800g with normal maternal pelvis.
    • Breech presentation occurred in 173 cases, with 102 eligible for a trial of vaginal delivery.

    Purpose:

    • To analyze maternal and fetal factors associated with breech presentation.
    • To evaluate the safety and outcomes of a selective vaginal breech delivery protocol.
    • To compare neonatal and developmental outcomes between vaginal and abdominal breech deliveries.

    Summary:

    • Seventy-seven of 102 eligible breech presentations were delivered vaginally.
    • Vaginally delivered breech infants showed higher rates of low Apgar scores at one minute but not at five minutes.

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  • Long-term follow-up revealed developmental disturbances in both vaginal (3/77) and abdominal (5/71) breech deliveries.

    • Impact:

    • Breech presentation is linked to increased primiparity and light-for-dates infants.
    • Perinatal mortality rates were higher in breech presentations (17.3/1000) versus cephalic (4.7/1000), decreasing to 5.8/1000 and 3.8/1000 respectively after correcting for malformations.
    • Findings support careful patient selection for vaginal breech delivery to optimize neonatal outcomes.