Breech at term: caesarean versus vaginal delivery

Abstract

OBJECTIVE: In 3-4% of the pregnancies, the fetus will be in breech presentation at term. For most of these women the approach to delivery is controversial. The objective of the study was to compare the pregnancy outcomes of breech presentations at term delivered vaginally and by caesarean section METHODS: Hospital based cohort study. Study sample was all breech presentations at term with a singleton fetus delivering at Teaching Hospital, Galle during the specified period of study. Decision regarding the suitability for vaginal delivery was made by individual consultants of respective units as per unit protocols. Outcome measures were defined and data collected for each delivery on a printed data sheet. Results: The two study groups were comparable with regard to the basic characteristics and the presence of antenatal complications. There was no significant difference between the two study groups with regard to serious maternal morbidity (RR 1.08, 95% CI 0.75-1.56), neonatal mortality (RR 1.07, 95%CI 0.61- 1.90) or serious neonatal morbidity (RR 1.23,95% CI 0.76- 2.00) Discussion: In our study group there was no significant difference in maternal and neonatal outcomes between the vaginal delivery and the caesarean section.