Term Breech Presentation and Timing of Delivery.

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Outcomes Research

Background:

• Breech presentation is a primary reason for cesarean delivery (CD), but optimal timing for CD remains unclear.
• Maternal and fetal complications associated with breech presentation CD timing require further investigation.

Purpose of the Study:

• To investigate the impact of gestational age at cesarean delivery (CD) for breech presentation on maternal and fetal complications.
• To identify the optimal gestational age window for CD in breech presentation to minimize adverse outcomes.

Main Methods:

• Retrospective study of 468 term singleton breech presentation CDs from February 2020 to January 2022.
• Maternal and neonatal outcomes were compared across different gestational age groups at CD.
• Logistic regression models were used to adjust for potential confounding factors.

Main Results:

• Cesarean deliveries (CDs) at 39+0 to 39+6 weeks showed better maternal outcomes and lower rates of emergent CDs compared to earlier or later gestations.
• Maternal adverse outcomes were significantly higher for CDs performed at ≥40 weeks gestation (adjusted OR 2.094).
• Emergent CDs were more frequent in both earlier (37+0 to 38+6 weeks, adjusted OR 1.65) and later (≥40 weeks, adjusted OR 2.407) gestational age groups.

Conclusions:

• Cesarean delivery (CD) for breech presentation between 39+0 and 39+6 weeks is associated with improved maternal outcomes.
• Performing CD for breech presentation at 39+0 to 39+6 weeks is linked to a reduced rate of emergent procedures.
• Delaying CD beyond 39+6 weeks for breech presentation may increase maternal complication risks.