Vaginal breech delivery: is it still an option?

OBJECTIVE

To provide local data on term breech delivery for future guidance.

STUDY

DESIGN

Retrospective, 'intended-mode-of-delivery' analysis of 711 antenatally uncomplicated singleton breech deliveries at >or=37 weeks: 445 (63%) planned for vaginal delivery (VD) (no fetal growth restriction, fetal weight 2000-4000 g, adequate pelvic size, maternal consent) and 266 for cesarean section (CS).

OUTCOME MEASURES: Apgar score, cord blood acid-base status, childhood deaths and disability.

RESULTS

Perinatal mortality was nil in both groups. Low 1-min Apgar scores and low arterial cord blood pH were significantly more frequent in planned VD, but not low Apgar scores at 5 or 10 min or low venous pH. Metabolic acidosis, neonatal intensive care, neonatal seizures, birth trauma, childhood death (CS=1), and neurodevelopmental handicaps (CS=2, VD=1) were equally common.

CONCLUSION

Our results do not disqualify selective vaginal breech delivery at term and beyond as an option.