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Management of term breech presentation in primigravidae
British Journal of Obstetrics and Gynaecology
|July 1, 1981
Summary
Vaginal delivery for term breech presentations in first-time mothers (primigravidae) resulted in 81% success with no perinatal deaths. While Erb
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Fetal Health
Background:
- Breech presentation at term is a significant obstetric challenge.
- Vaginal delivery of breech presentation carries potential risks for the fetus.
Purpose of the Study:
- To evaluate the safety and outcomes of planned vaginal delivery for term breech presentations in primigravidae.
- To identify factors influencing the success of vaginal breech delivery.
Main Methods:
- Prospective study of 231 term breech presentations in primigravidae.
- Vaginal delivery was attempted unless specific contraindications were met.
- Caesarean section was performed for fetal distress, cord prolapse, abnormal uterine activity, or radiographic pelvimetry findings.
Main Results:
- 81% (260/231) of term breech presentations were delivered vaginally.
- No perinatal mortality was observed in the vaginal delivery group.
- One case of Erb's palsy and one infant with Apgar score < 7 at 5 minutes were recorded.
- 17 patients initially selected for vaginal delivery required intrapartum caesarean section.
Conclusions:
- Vaginal delivery of term breech presentation in primigravidae can be achieved with low perinatal mortality and morbidity.
- Careful patient selection and intrapartum monitoring are crucial for successful vaginal breech delivery.
- Radiographic pelvimetry and fetal head extension are important considerations for delivery mode selection.