E O Orji1, K O Ajenifuja. 1. Department of Obstetrics, Gynaecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ife-Ife, Nigeria.
Abstract
BACKGROUND: The optimum mode of breech delivery remains a matter of controversy among obstetricians worldwide. OBJECTIVE: To determine whether term breech babies born by planned vaginal delivery are at higher risk of neonatal mortality and morbidity than those born by planned caesarean delivery. DESIGN: A hospital based non-experimental comparison of outcome of breech delivery. SETTING: Ife State Hospitals Complex, Ile-Ife. SUBJECTS: Two hundred and fourty four singleton breech deliveries occurring at term. MAIN OUTCOME MEASURES: They include low 5-minute Apgar score, birth trauma, maternal and perinatal morbidity and mortality. RESULTS: The perinatal mortality was not significantly different in both groups: OR 2.7 (95% C.I. 0.3-26.8). The low 5-minute Apgar scores were higher in the planned vaginal delivery OR 9.0 (95% C.I. 1-73.4), but the traumatic morbidity was not (OR 1.8, 95% C.I. 0.2-20.1). Maternal morbidity occurred more in the planned Caesarean delivery group OR 0.4 (95% C.I. 0.2-0.9). CONCLUSION: Given appropriate selection criteria and management protocol, the outcome from elective caesarean section might not be better than from planned vaginal delivery.
BACKGROUND: The optimum mode of breech delivery remains a matter of controversy among obstetricians worldwide. OBJECTIVE: To determine whether term breech babies born by planned vaginal delivery are at higher risk of neonatal mortality and morbidity than those born by planned caesarean delivery. DESIGN: A hospital based non-experimental comparison of outcome of breech delivery. SETTING: Ife State Hospitals Complex, Ile-Ife. SUBJECTS: Two hundred and fourty four singleton breech deliveries occurring at term. MAIN OUTCOME MEASURES: They include low 5-minute Apgar score, birth trauma, maternal and perinatal morbidity and mortality. RESULTS: The perinatal mortality was not significantly different in both groups: OR 2.7 (95% C.I. 0.3-26.8). The low 5-minute Apgar scores were higher in the planned vaginal delivery OR 9.0 (95% C.I. 1-73.4), but the traumatic morbidity was not (OR 1.8, 95% C.I. 0.2-20.1). Maternal morbidity occurred more in the planned Caesarean delivery group OR 0.4 (95% C.I. 0.2-0.9). CONCLUSION: Given appropriate selection criteria and management protocol, the outcome from elective caesarean section might not be better than from planned vaginal delivery.
Authors: Cassandra R Duffy; Janet L Moore; Sarah Saleem; Antoinette Tshefu; Carl L Bose; Elwyn Chomba; Waldemar A Carlo; Ana L Garces; Nancy F Krebs; K Michael Hambidge; Shivaprasad S Goudar; Richard J Derman; Archana Patel; Patricia L Hibberd; Fabian Esamai; Edward A Liechty; Dennis D Wallace; Elizabeth M McClure; Robert L Goldenberg Journal: Acta Obstet Gynecol Scand Date: 2018-12-20 Impact factor: 3.636