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[Pelvic presentation, always cesarean?]
E S Neri Ruiz1, E Valerio Castro, R Cárdenas Arias
1Hospital Central Militar, Méx., D.F.
Ginecologia Y Obstetricia De Mexico
|January 24, 1998
Summary
Vaginal delivery for term breech presentation is a viable option with careful patient selection and skilled practitioners, leading to lower maternal morbidity. Neonatal outcomes were comparable to cesarean births.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Fetal Medicine
Context:
- Fetal presentation, particularly term breech, poses delivery challenges.
- Cesarean delivery is frequently employed for fetal presentation, but carries maternal risks.
Purpose:
- To evaluate the safety and outcomes of vaginal delivery for term breech presentation compared to cesarean delivery.
Summary:
- This study analyzed 104 term breech presentations. Cesarean delivery was performed in 75%, with common indications including deflexionated head and prior cesarean. Vaginal delivery was attempted in only 14.4% of eligible cases. Neonatal mortality was low (34.4/1000 live births), with one death due to congenital malformations in the vaginal delivery group. Severe perinatal asphyxia rates did not differ significantly between vaginal and cesarean births. Maternal morbidity was significantly higher in the cesarean group (20.3%) compared to vaginal delivery (0%).
Impact:
- Selected vaginal breech deliveries demonstrate favorable fetal outcomes and significantly reduced maternal morbidity.
- Highlights the importance of physician training and careful patient selection for successful vaginal breech deliveries.