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Comparison of vaginal and cesarean section delivery for fetuses in breech presentation.
J Perinat Med. 1999; 27(5):339-51.JP

Abstract

OBJECTIVES

Our purpose was to evaluate the perinatal mortality and morbidity of deliveries with fetuses presenting by the breech comparing outcomes of two groups according to mode of delivery: vaginal and cesarean section.

RESULTS

Of 756 fetuses studied, 271 were delivered vaginally and 485 by cesarean section. In infants weighing > or = 1500 grams, "further corrected" mortality and morbidity rates were low and similar for both delivery routes: one neonatal death (NNM) in each. Among very low birth weight (VLBW) infants (< 1500 grams) the "further corrected" mortality rate was higher in the vaginal group: 57.4%, and 18.0% in abdominal deliveries (odds ratio [OR] = 6.1, 95% CI: 3.1 to 12.1). Likewise, rate of depression at five minutes were higher in the vaginal group (p < 0.001). However, the average fetal weight among the vaginal deliveries VLBW (787 grams) was 250 grams less than in the cesarean section group (1040 grams). After adjustment for fetal weight, gestational age, and other prognostic variables the odds ratio for neonatal death was no longer statistically significant (adjusted OR = 2.1, 95% CI: 0.9 to 5.2, p = 0.105). Comparison of planned vaginal delivery with elective cesarean section yielded smaller differences (adjusted OR for neonatal death = 1.3, 95% CI: 0.6 to 2.9, p = 0.525).

CONCLUSION

The poor perinatal outcomes of breech delivered infants are due primarily to VLBW, congenital malformations, and premature labor. Although abdominal delivery had a lower NNM rate than vaginal delivery, the difference was not significant after adjustment for confounding factors. The results confirm the findings of a previously analyzed similar series delivered at our institution between 1980 and 1987. They suggest that, with appropriate technique, abdominal delivery is not mandatory in breech presentation.

Authors+Show Affiliations

Department of Obstetrics, University of Chicago, Illinois, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10642954

Citation

Ismail, M A., et al. "Comparison of Vaginal and Cesarean Section Delivery for Fetuses in Breech Presentation." Journal of Perinatal Medicine, vol. 27, no. 5, 1999, pp. 339-51.
Ismail MA, Nagib N, Ismail T, et al. Comparison of vaginal and cesarean section delivery for fetuses in breech presentation. J Perinat Med. 1999;27(5):339-51.
Ismail, M. A., Nagib, N., Ismail, T., & Cibils, L. A. (1999). Comparison of vaginal and cesarean section delivery for fetuses in breech presentation. Journal of Perinatal Medicine, 27(5), 339-51.
Ismail MA, et al. Comparison of Vaginal and Cesarean Section Delivery for Fetuses in Breech Presentation. J Perinat Med. 1999;27(5):339-51. PubMed PMID: 10642954.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of vaginal and cesarean section delivery for fetuses in breech presentation. AU - Ismail,M A, AU - Nagib,N, AU - Ismail,T, AU - Cibils,L A, PY - 2000/1/22/pubmed PY - 2000/1/22/medline PY - 2000/1/22/entrez SP - 339 EP - 51 JF - Journal of perinatal medicine JO - J Perinat Med VL - 27 IS - 5 N2 - OBJECTIVES: Our purpose was to evaluate the perinatal mortality and morbidity of deliveries with fetuses presenting by the breech comparing outcomes of two groups according to mode of delivery: vaginal and cesarean section. RESULTS: Of 756 fetuses studied, 271 were delivered vaginally and 485 by cesarean section. In infants weighing > or = 1500 grams, "further corrected" mortality and morbidity rates were low and similar for both delivery routes: one neonatal death (NNM) in each. Among very low birth weight (VLBW) infants (< 1500 grams) the "further corrected" mortality rate was higher in the vaginal group: 57.4%, and 18.0% in abdominal deliveries (odds ratio [OR] = 6.1, 95% CI: 3.1 to 12.1). Likewise, rate of depression at five minutes were higher in the vaginal group (p < 0.001). However, the average fetal weight among the vaginal deliveries VLBW (787 grams) was 250 grams less than in the cesarean section group (1040 grams). After adjustment for fetal weight, gestational age, and other prognostic variables the odds ratio for neonatal death was no longer statistically significant (adjusted OR = 2.1, 95% CI: 0.9 to 5.2, p = 0.105). Comparison of planned vaginal delivery with elective cesarean section yielded smaller differences (adjusted OR for neonatal death = 1.3, 95% CI: 0.6 to 2.9, p = 0.525). CONCLUSION: The poor perinatal outcomes of breech delivered infants are due primarily to VLBW, congenital malformations, and premature labor. Although abdominal delivery had a lower NNM rate than vaginal delivery, the difference was not significant after adjustment for confounding factors. The results confirm the findings of a previously analyzed similar series delivered at our institution between 1980 and 1987. They suggest that, with appropriate technique, abdominal delivery is not mandatory in breech presentation. SN - 0300-5577 UR - https://www.unboundmedicine.com/medline/citation/10642954/Comparison_of_vaginal_and_cesarean_section_delivery_for_fetuses_in_breech_presentation_ L2 - https://www.degruyter.com/document/doi/10.1515/JPM.1999.047 DB - PRIME DP - Unbound Medicine ER -