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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Undiagnosed breech
E C Nwosu1, S Walkinshaw, P Chia
1Department of Obstetrics and Gynaecology, Liverpool Maternity Hospital, UK.
British Journal of Obstetrics and Gynaecology
|June 1, 1993
Summary
Many breech presentations are diagnosed during labor. These undiagnosed breeches have similar outcomes to diagnosed breeches, suggesting no need for automatic cesarean delivery.
Area of Science:
- Obstetrics
- Maternal-Fetal Medicine
- Neonatal Outcomes
Background:
- Breech presentation is a common obstetric complication.
- Timely diagnosis and management are crucial for optimal maternal and infant outcomes.
- Antenatal surveillance aims to detect breech presentations before labor.
Purpose of the Study:
- To determine the proportion of breech presentations diagnosed during labor.
- To compare the outcomes of breech presentations diagnosed in labor versus those diagnosed antenatally.
- To evaluate the safety of vaginal delivery for undiagnosed breech presentations.
Main Methods:
- Retrospective review of 305 singleton breech presentations.
- Cases were categorized based on diagnosis timing: antenatal vs. during labor.
- Outcomes assessed included delivery mode, birthweight, short-term morbidity, and Apgar scores.
Main Results:
- 79 (25.9%) breech presentations were diagnosed for the first time during labor.
- Undiagnosed breeches were more likely to have a vaginal delivery (OR 1.68).
- No significant short-term morbidity or mortality was associated with vaginal breech delivery in undiagnosed cases.
Conclusions:
- A substantial proportion of breech presentations are detected late, during labor.
- Undiagnosed breech presentations appear to have favorable outcomes with vaginal delivery.
- Routine cesarean section for all undiagnosed breeches is not supported by these findings.
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