Outcome of term breech by intended mode of delivery.

BACKGROUND

The optimal mode of delivery for the term breech fetus is undetermined.

METHODS

Over a 10-year period, the outcome of 157 planned caesarean sections and 265 trials of vaginal delivery for the matured, selected, singleton breech presentation were compared.

RESULTS

The perinatal mortality among the planned vaginal group was not statistically different from the planned caesarean group (3.0% vs 0.6%, p = 0.102), so was the incidence of birth asphyxia (9.4% vs 4.5%, p = 0.06), admission into neonatal intensive care unit (13.6 vs 7.6%, p = 0.063) and neonatal birth injury (3.4% vs 0.6%, p = 0.072). The overall maternal morbidity was 28% in the planned caesarean group, and 9% in the planned vaginal group, p = 0.025.

CONCLUSION

Given appropriate selection criteria and management protocol, the outcome from elective caesarean section might not be better than that from planned vaginal delivery.