Breech presentation: a retrospective analysis of 12-years' experience at a single center.

OBJECTIVE

To investigate neonatal outcome after breech presentation in term pregnancies.

STUDY

DESIGN

Data from 1345 term breech deliveries over a 12-year study period were retrospectively reviewed. Neonatal morbidity and mortality were compared by route of delivery.

RESULTS

We investigated 1345 term breech deliveries. A total of 1041 patients (77.4%) attempted a vaginal delivery; of these, 808 (60.1%) were delivered vaginally and 233 patients (17.3%) who failed at vaginal birth underwent cesarean section. The other 304 women (22.6%) were delivered by a planned cesarean section. No statistical differences were found in the incidence of low 5-minute Apgar scores and arterial cord blood pH values<or=7. Admission to neonatal units was higher after vaginal delivery than after elective cesarean section (55.0% vs. 20.0%). The difference between vaginal delivery and cesarean section in the rate of severe plexus injuries was statistically significant (P=0.0025). Two neonatal deaths occurred at term after a trial of labor. No perinatal death of a term breech infant occurred in the cesarean section group.

CONCLUSION

The increased risk of birth trauma and admission to a neonatal intensive care unit after vaginal delivery emphasizes the advantages of a planned cesarean section for a breech presentation.