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Trend in breech delivery in Saudi Arabia
S K Chattopadhyay1, B S Sengupta, M H Zaidi
1Maternity and Children's Hospital, Riyadh, Saudi Arabia.
Summary
Caesarean section (CS) significantly improved neonatal outcomes for breech deliveries compared to vaginal birth. However, factors like social conservatism and limited facilities hindered higher CS rates.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Public Health
Background:
- Singleton breech presentation complicates delivery, posing risks to neonates.
- Vaginal delivery of breech infants is associated with higher neonatal mortality and morbidity.
- Caesarean section (CS) is an alternative delivery method for breech presentations.
Purpose of the Study:
- To evaluate the impact of Caesarean section (CS) on neonatal mortality and morbidity in singleton breech deliveries.
- To compare outcomes between CS and vaginal delivery for breech presentation.
- To identify factors influencing the adoption of CS for breech deliveries.
Main Methods:
- Retrospective analysis of 2,168 singleton breech deliveries.
- Comparison of neonatal mortality and morbidity rates between CS and vaginal delivery groups.
- Analysis of perinatal mortality (PNM) and neonatal death (NND) rates stratified by birth weight and delivery mode.
Main Results:
- CS delivery showed significantly lower neonatal mortality and morbidity rates compared to vaginal delivery (p < 0.001).
- The uncorrected perinatal mortality (PNM) rate was 90.4/1,000, 2.5 times the overall hospital PNM.
- Neonatal death (NND) rates were significantly higher for low birth-weight infants (<2,500g) in the vaginal delivery group (206/1,000) versus heavier infants (18/1,000).
- No significant difference in NND rates was observed between birth-weight groups for CS deliveries (p > 0.3).
Conclusions:
- Caesarean section significantly improves neonatal outcomes in singleton breech deliveries.
- Low birth weight is a critical factor increasing neonatal death risk during vaginal breech delivery.
- Social conservatism, large family size, and inadequate neonatal care facilities impede higher CS rates for breech presentations.