Planned vaginal delivery versus Caesarean section for breech presentation in Ile-Ife, Nigeria.

BACKGROUND

The optimum mode of breech delivery remains a matter of controversy among obstetricians worldwide.

OBJECTIVE

To determine whether term breech babies born by planned vaginal delivery are at higher risk of neonatal mortality and morbidity than those born by planned caesarean delivery.

DESIGN

A hospital based non-experimental comparison of outcome of breech delivery.

SETTING

Ife State Hospitals Complex, Ile-Ife.

SUBJECTS: Two hundred and fourty four singleton breech deliveries occurring at term.

MAIN OUTCOME MEASURES: They include low 5-minute Apgar score, birth trauma, maternal and perinatal morbidity and mortality.

RESULTS

The perinatal mortality was not significantly different in both groups: OR 2.7 (95% C.I. 0.3-26.8). The low 5-minute Apgar scores were higher in the planned vaginal delivery OR 9.0 (95% C.I. 1-73.4), but the traumatic morbidity was not (OR 1.8, 95% C.I. 0.2-20.1). Maternal morbidity occurred more in the planned Caesarean delivery group OR 0.4 (95% C.I. 0.2-0.9).

CONCLUSION

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