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Breech delivery. An obstetrical analysis.

P Oian1, I Skråmm, E Hannisdal

  • 1Department of Obstetrics and Gynaecology, National Hospital, University of Oslo.

Acta Obstetricia Et Gynecologica Scandinavica
|January 1, 1988
PubMed
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Neonatal mortality in breech births is 4.1%, with low birth weight being the primary risk factor. Other risks include maternal diabetes, malformations, and low Apgar scores, not improved by cesarean section.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Perinatal Epidemiology

Background:

  • Breech presentation complicates approximately 3-4% of deliveries.
  • Neonatal mortality rates in breech births have historically been higher than in cephalic presentations.
  • Identifying risk factors is crucial for improving perinatal outcomes.

Purpose of the Study:

  • To analyze factors associated with neonatal mortality in breech deliveries.
  • To identify significant risk factors for neonatal death in this cohort.
  • To evaluate the impact of cesarean section rates on neonatal mortality.

Main Methods:

  • Retrospective analysis of 580 consecutive breech births from 1972-1979.
  • Multivariate logistic regression analysis of 56 variables.

Related Experiment Videos

  • Comparison of neonatal mortality rates between vaginal and cesarean deliveries.

    • Main Results:

    • Overall neonatal mortality was 4.1%.
    • Significant risk factors identified: low birth weight (most critical), maternal diabetes, malformations, and Apgar score < 7 at 5 minutes.
    • Cesarean section rates increased from 8.1% to 32.6% (1972-75 vs. 1976-79) without reducing neonatal mortality.

    Conclusions:

    • Low birth weight is the most significant predictor of neonatal death in breech deliveries.
    • Increased cesarean section rates did not improve neonatal survival in this series.
    • Management strategies should focus on addressing identified risk factors rather than solely on mode of delivery.