BACKGROUND: The purpose of this study was to compare delivery mode and neonatal outcome in breech pregnancies diagnosed antepartum (Dx group) with those diagnosed on admission for delivery or intrapartum (No-Dx group). METHODS: During an 11-year period, breech pregnancies >/=34 weeks' gestation with a live nonanomalous fetus were reviewed. The Dx group was matched for gestational age, parity, and maternal age to the No-Dx group (n = 256) and compared using the chi2-test, the Mc-Nemar test, and the Wilcoxon rank test. A p-value of < 0.05 was considered significant. RESULTS: Breech type and birthweights were similar in the two groups. In the No-Dx group, 19.5% did not receive prenatal care. More patients in the No-Dx group were admitted with cervical dilation > 4 cm (39.4% vs. 27.0%, p = 0.004), whereas 17.1% of patients in the Dx group were admitted for elective cesarean delivery at term. There was a higher cesarean delivery rate in the Dx group (64.1% vs. 50.8%, p = 0.003), specifically for arrest disorders (15.2% vs. 6.9%, p = 0.008). The neonatal outcome in the two groups was similar regarding Apgar scores, intensive care nursery admission, need for mechanical ventilation, neonatal death, and length of nursery stay. CONCLUSIONS: Antepartum diagnosis of breech presentation decreases the threshold for cesarean delivery. Failure to diagnose breech antepartum does not compromise neonatal outcome.
BACKGROUND: The purpose of this study was to compare delivery mode and neonatal outcome in breech pregnancies diagnosed antepartum (Dx group) with those diagnosed on admission for delivery or intrapartum (No-Dx group). METHODS: During an 11-year period, breech pregnancies >/=34 weeks' gestation with a live nonanomalous fetus were reviewed. The Dx group was matched for gestational age, parity, and maternal age to the No-Dx group (n = 256) and compared using the chi2-test, the Mc-Nemar test, and the Wilcoxon rank test. A p-value of < 0.05 was considered significant. RESULTS: Breech type and birthweights were similar in the two groups. In the No-Dx group, 19.5% did not receive prenatal care. More patients in the No-Dx group were admitted with cervical dilation > 4 cm (39.4% vs. 27.0%, p = 0.004), whereas 17.1% of patients in the Dx group were admitted for elective cesarean delivery at term. There was a higher cesarean delivery rate in the Dx group (64.1% vs. 50.8%, p = 0.003), specifically for arrest disorders (15.2% vs. 6.9%, p = 0.008). The neonatal outcome in the two groups was similar regarding Apgar scores, intensive care nursery admission, need for mechanical ventilation, neonatal death, and length of nursery stay. CONCLUSIONS: Antepartum diagnosis of breech presentation decreases the threshold for cesarean delivery. Failure to diagnose breech antepartum does not compromise neonatal outcome.