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Perinatal mortality and route of delivery in term breech presentations
A Lindqvist1, S Nordén-Lindeberg, U Hanson
1Department of Obstetrics and Gynaecology, Orebro Medical Center Hospital, Sweden.
Objective:
To compare intrapartum related infant mortality in term (> 34 weeks) breech presentations in relation to vaginal delivery or delivery by caesarean section.
Design:
Register based nationwide study.
Setting:
Sweden from 1991 to 1992.
Participants:
6542 singleton fetuses born in the breech presentation.
Main Outcome Measures:
Intrapartum and early neonatal deaths, stillbirths and congenital malformations, low Apgar score < 7 at 5 min, mode of delivery.
Results:
After exclusion of antepartum stillbirths and congenital malformation, the intrapartum and early neonatal mortality rate was 2/2248 (0.09%) in the group delivered vaginally and 2/4029 (0.05%) in the group delivered by caesarean section. The relative risk was 1.81 (95% CI 0.26-12.84). Thus the difference was not statistically significant. This result was further supported after reviewing individual cases.
Conclusions:
The intrapartum related mortality in the group delivered vaginally was low and the result could not verify an increased mortality in term breech presentations delivered vaginally compared with those delivered by caesarean section.