M R Koo1, G A Dekker, H P van Geijn. 1. Department of Gynecology and Obstetrics, Free University Hospital, Amsterdam, The Netherlands.
Abstract
OBJECTIVE: To assess neonatal morbidity and mortality in singleton term infants delivered in breech presentation and to find a possible correlation between outcome and mode of delivery. STUDY DESIGN: Case study of 306 singleton, term (37-42 weeks), breech deliveries, that took place between 1989 and 1994 in one perinatal centre. RESULTS: 170 infants were delivered vaginally, 72 by elective and 64 by secondary cesarean section. Even after application of strict selection criteria -- i.e. prior pelvic assessment by staff obstetricians, an estimated birth weight of 2500-4000 g -- and with staff supervision, vaginal delivery turned out to be associated with a significantly higher incidence of low umbilical artery pH values and neonatal care unit admissions as compared to elective cesarean section. Five infants suffered mechanical trauma. One neonatal death occurred in the vaginal delivery group. CONCLUSION: The results of this retrospective study of 306 singleton term breech deliveries imply that even after strict selection of patients, vaginal delivery is associated with increased neonatal morbidity in comparison to elective cesarean section.
OBJECTIVE: To assess neonatal morbidity and mortality in singleton term infants delivered in breech presentation and to find a possible correlation between outcome and mode of delivery. STUDY DESIGN: Case study of 306 singleton, term (37-42 weeks), breech deliveries, that took place between 1989 and 1994 in one perinatal centre. RESULTS: 170 infants were delivered vaginally, 72 by elective and 64 by secondary cesarean section. Even after application of strict selection criteria -- i.e. prior pelvic assessment by staff obstetricians, an estimated birth weight of 2500-4000 g -- and with staff supervision, vaginal delivery turned out to be associated with a significantly higher incidence of low umbilical artery pH values and neonatal care unit admissions as compared to elective cesarean section. Five infants suffered mechanical trauma. One neonatal death occurred in the vaginal delivery group. CONCLUSION: The results of this retrospective study of 306 singleton term breech deliveries imply that even after strict selection of patients, vaginal delivery is associated with increased neonatal morbidity in comparison to elective cesarean section.