Delivery type and neonatal mortality among 10,749 breeches

Data on 10,749 breech presentations were analyzed for the effect of delivery type on neonatal mortality. Most of the data are from developing countries, and most of the hospitals have higher mortality than is found in Europe or the United States. The simultaneous effect of type of hospital where the delivery occurred, type of breech, birthweight, and parity were examined. The benefit of cesarean delivery was greater for nulliparae than multiparae, greater for footlings than for frank or complete breeches, and greater for larger babies than smaller ones. This last finding probably reflects the quality of neonatal care in developing country hospitals rather than the value of cesarean section. Maternal mortality and morbidity was higher among women delivered abdominally than among those delivered vaginally.