Breech delivery: impact of increasing cesarean section delivery

We present a retrospective analysis of neonatal outcome and maternal morbidity in the delivery of 192 infants presenting by the breech position, weighing more than 1,000 gm, and exhibiting fetal heart tones upon admission. All of the deliveries occurred between Jan 1, 1975 and Dec 31, 1978. Over the study period the cesarean section rate increased from 35.9% to 73.3%, and maternal morbidity increased from 17.9% to 35.0%. Maternal morbidity in the cesarean section group in 1978 was 41%. Three of the four neonatal deaths were attributed to anomalies group in 1978 was 41%. Three of the four neonatal deaths were attributed to anomalies incompatible with life, and the fourth was due to severe respiratory distress syndrome in a markedly premature infant. Traumatic neonatal morbidity occurred almost exclusively in the vaginally delivered group with only one case of traumatic morbidity in the cesarean section group. Apgar scores of the infants weighing less than 2,500 gm were significantly improved in the cesarean section group (P less than .01), but no significant difference was seen in the five-minute Apgar score in the infants weighing more than 2,500 gm.