[Breech presentation and its significance (author's transl)]

Area of Science:

• Obstetrics and Gynecology
• Perinatology
• Neonatal Medicine

Context:

• Breech presentation occurs in approximately 3.6% of deliveries.
• Maternal age and parity influenced breech presentation incidence.
• Frank and full breech presentations were most common, while knee presentations were rare.

Purpose:

• To compare breech delivery outcomes between two distinct time periods (1959-1965 and 1966-1975).
• To analyze trends in delivery methods, including the incidence of Cesarean sections and the use of the Bracht maneuver.
• To evaluate perinatal complications, mortality rates, and birth trauma associated with breech presentations.

Summary:

• The study observed a significant increase in Cesarean section rates for breech presentations, rising from 6% to 21% between the two periods, with rates reaching approximately 30% in the latter years.
• The Bracht maneuver was the primary delivery method in over 80% of cases, while complete breech extractions decreased.
• Perinatal mortality in breech deliveries was 7.2% for infants over 1000 grams, with prematurity accounting for a substantial proportion of deaths (88.2% of 102 perinatal deaths).
• Birth trauma rates decreased from 6.3% in the first period to 2.7% in the second period.

Impact:

• The findings highlight a significant shift towards Cesarean sections for breech presentations, reflecting evolving obstetric practices.
• The reduction in birth trauma suggests improvements in clinical management and techniques for breech deliveries.
• Understanding these trends is crucial for optimizing perinatal care and outcomes for infants with breech presentation.