Term breech delivery. Early and late complications

Area of Science:

• Obstetrics
• Perinatal Medicine
• Neonatal Outcomes

Background:

• Breech presentation delivery presents unique challenges for fetal well-being.
• Vaginal breech delivery outcomes are influenced by various clinical factors.
• Cesarean section (CS) rates for breech presentations have historically varied.

Purpose of the Study:

• To analyze clinical factors linked to fetal complications in vaginal breech deliveries.
• To assess the impact of changing cesarean section rates on fetal complications.
• To evaluate long-term outcomes in infants experiencing complications.

Main Methods:

• Retrospective analysis of 366 singleton breech presentations.
• Correlation of birth outcomes with maternal pre-pregnancy weight and fetal head size.
• Tracking of cesarean section rates and traumatic morbidity over the study period.
• Follow-up assessment of infants for significant effects and psychomotor development.

Main Results:

• Vaginal delivery outcomes correlated with maternal weight and fetal head size.
• Increasing cesarean section rates (20% to 50%) corresponded with reduced traumatic morbidity.
• No significant long-term effects were observed in most infants.
• Fetal asphyxia rates remained unaffected by the increased cesarean section rate.

Conclusions:

• While increased cesarean sections reduced traumatic morbidity in breech presentations, they did not lower asphyxia rates.
• Maternal and fetal factors remain crucial in predicting outcomes for vaginal breech deliveries.
• Long-term neurodevelopmental follow-up is important for infants experiencing birth asphyxia.