Tags

Type your tag names separated by a space and hit enter

Planned vaginal delivery versus elective caesarean section in singleton term breech presentation: a study of 1116 cases.
Eur J Obstet Gynecol Reprod Biol. 2001 Oct; 98(2):186-92.EJ

Abstract

OBJECTIVE

To compare neonatal and maternal morbidity and mortality between planned vaginal delivery and elective cesarean section for singleton term breech presentation.

STUDY DESIGN

We studied retrospectively all deliveries of singleton breech presentations at term in the public Hospitals of Lyon between 1 January 1991 and 31 December 1995. To take only the effect of delivery on the fetus into account, we eliminated high risk pregnancies and fetal malformations. Fetal parameters were corrected perinatal mortality, Apgar score<7 at 1 and 5 min, umbilical cord arterial pH<7.15, neurological disorders, trauma and need for neonatal intensive care. Maternal parameters were mild, moderate and severe complications.

RESULTS

Of the 1116 breech presentations, 702 (62.9%) underwent an elective caesarean section and 414 (37.1%) a planned vaginal delivery. In the latter group, 342 (30.6%) had a vaginal delivery and 72 (6.5%) a non-elective caesarean section. Infants for whom the vaginal route was planned were at higher risk of mortality and morbidity. There were 2 deaths in this group and none in the elective caesarean section group and all fetal parameters were poorer: more Apgar<7 at 5 min (RR: relative risk=3.05; 1.03-9.05), arterial pH<7.15 (RR=1.64; 1.11-2.43), intubations (RR=7.35; 2.10-25.6), neurological disorders, trauma (RR=4.24; 1.66-10.8), transfer to intensive care units (RR=3.23; 1.57-6.64). The overall maternal morbidity was lower in the planned vaginal delivery group (RR=0.65; 0.44-0.94) but this was only because of less mild complications. The moderate and severe complications were the same in the two groups (RR=0.97; 0.59-1.57).

CONCLUSIONS

Planned vaginal delivery in singleton term breech presentation increases the risk of death and of neonatal complications. Elective caesarean section increases the risk of only mild maternal complications. For these reasons, elective caesarean section should be preferred for singleton term breech presentations.

Authors+Show Affiliations

Department of Obstetrics, Claude Bernard University, Hôtel Dieu Hospital, School of Medicine, Lyon, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11574129

Citation

Golfier, F, et al. "Planned Vaginal Delivery Versus Elective Caesarean Section in Singleton Term Breech Presentation: a Study of 1116 Cases." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 98, no. 2, 2001, pp. 186-92.
Golfier F, Vaudoyer F, Ecochard R, et al. Planned vaginal delivery versus elective caesarean section in singleton term breech presentation: a study of 1116 cases. Eur J Obstet Gynecol Reprod Biol. 2001;98(2):186-92.
Golfier, F., Vaudoyer, F., Ecochard, R., Champion, F., Audra, P., & Raudrant, D. (2001). Planned vaginal delivery versus elective caesarean section in singleton term breech presentation: a study of 1116 cases. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 98(2), 186-92.
Golfier F, et al. Planned Vaginal Delivery Versus Elective Caesarean Section in Singleton Term Breech Presentation: a Study of 1116 Cases. Eur J Obstet Gynecol Reprod Biol. 2001;98(2):186-92. PubMed PMID: 11574129.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Planned vaginal delivery versus elective caesarean section in singleton term breech presentation: a study of 1116 cases. AU - Golfier,F, AU - Vaudoyer,F, AU - Ecochard,R, AU - Champion,F, AU - Audra,P, AU - Raudrant,D, PY - 2001/9/28/pubmed PY - 2002/1/11/medline PY - 2001/9/28/entrez SP - 186 EP - 92 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur J Obstet Gynecol Reprod Biol VL - 98 IS - 2 N2 - OBJECTIVE: To compare neonatal and maternal morbidity and mortality between planned vaginal delivery and elective cesarean section for singleton term breech presentation. STUDY DESIGN: We studied retrospectively all deliveries of singleton breech presentations at term in the public Hospitals of Lyon between 1 January 1991 and 31 December 1995. To take only the effect of delivery on the fetus into account, we eliminated high risk pregnancies and fetal malformations. Fetal parameters were corrected perinatal mortality, Apgar score<7 at 1 and 5 min, umbilical cord arterial pH<7.15, neurological disorders, trauma and need for neonatal intensive care. Maternal parameters were mild, moderate and severe complications. RESULTS: Of the 1116 breech presentations, 702 (62.9%) underwent an elective caesarean section and 414 (37.1%) a planned vaginal delivery. In the latter group, 342 (30.6%) had a vaginal delivery and 72 (6.5%) a non-elective caesarean section. Infants for whom the vaginal route was planned were at higher risk of mortality and morbidity. There were 2 deaths in this group and none in the elective caesarean section group and all fetal parameters were poorer: more Apgar<7 at 5 min (RR: relative risk=3.05; 1.03-9.05), arterial pH<7.15 (RR=1.64; 1.11-2.43), intubations (RR=7.35; 2.10-25.6), neurological disorders, trauma (RR=4.24; 1.66-10.8), transfer to intensive care units (RR=3.23; 1.57-6.64). The overall maternal morbidity was lower in the planned vaginal delivery group (RR=0.65; 0.44-0.94) but this was only because of less mild complications. The moderate and severe complications were the same in the two groups (RR=0.97; 0.59-1.57). CONCLUSIONS: Planned vaginal delivery in singleton term breech presentation increases the risk of death and of neonatal complications. Elective caesarean section increases the risk of only mild maternal complications. For these reasons, elective caesarean section should be preferred for singleton term breech presentations. SN - 0301-2115 UR - https://www.unboundmedicine.com/medline/citation/11574129/Planned_vaginal_delivery_versus_elective_caesarean_section_in_singleton_term_breech_presentation:_a_study_of_1116_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301211501003335 DB - PRIME DP - Unbound Medicine ER -