TY - JOUR
T1 - Outcome of 496 term singleton breech deliveries in a tertiary center
AU - Daniel, Yair
AU - Fait, Gideon
AU - Lessing, Joseph B.
AU - Jaffa, Ariel
AU - David, Menachem P.
AU - Kupferminc, Michael J.
PY - 1998/2
Y1 - 1998/2
N2 - The study was conducted to compare the neonatal and maternal outcome of breech infants delivered vaginally at term with those delivered by cesarean section. All singleton term breech deliveries between January 1, 1992 and December 31, 1994 were reviewed (n = 496). Criteria for eligibility for vaginal trial of labor included: frank or complete breech presentation, estimated fetal weight of 2000-3800 g, no hyperextension of the fetal head and no history of uterine scar (group A, n = 283). Patients who did not fulfill these criteria, or had an abnormal pelvimetry, were delivered by cesarean section without a trial of labor (group B, n = 213). In group A, 226 patients (80%) delivered vaginally, and 57 (20%) patients underwent a cesarean section; 70% of the nulliparae and 89% of the multiparae delivered vaginally. No differences were observed between the groups in gestational week, number of nulliparae, pregnancy complications, and rates of epidural analgesia. However, maternal age and birth weight were significantly higher in group B. No maternal or perinatal mortality occurred. The incidences of 5- min Apgar score <7, birth trauma, neonatal complications, and neonatal intensive care unit admissions were similar between the groups and in the nulliparae and multiparae of each group. Maternal morbidity was significantly lower in patients who delivered vaginally. We conclude that a trial of labor in breech presentation based on appropriate selective criteria, and an active policy of labor management performed by experienced physicians, will facilitate safe delivery in most nulliparae and multiparae.
AB - The study was conducted to compare the neonatal and maternal outcome of breech infants delivered vaginally at term with those delivered by cesarean section. All singleton term breech deliveries between January 1, 1992 and December 31, 1994 were reviewed (n = 496). Criteria for eligibility for vaginal trial of labor included: frank or complete breech presentation, estimated fetal weight of 2000-3800 g, no hyperextension of the fetal head and no history of uterine scar (group A, n = 283). Patients who did not fulfill these criteria, or had an abnormal pelvimetry, were delivered by cesarean section without a trial of labor (group B, n = 213). In group A, 226 patients (80%) delivered vaginally, and 57 (20%) patients underwent a cesarean section; 70% of the nulliparae and 89% of the multiparae delivered vaginally. No differences were observed between the groups in gestational week, number of nulliparae, pregnancy complications, and rates of epidural analgesia. However, maternal age and birth weight were significantly higher in group B. No maternal or perinatal mortality occurred. The incidences of 5- min Apgar score <7, birth trauma, neonatal complications, and neonatal intensive care unit admissions were similar between the groups and in the nulliparae and multiparae of each group. Maternal morbidity was significantly lower in patients who delivered vaginally. We conclude that a trial of labor in breech presentation based on appropriate selective criteria, and an active policy of labor management performed by experienced physicians, will facilitate safe delivery in most nulliparae and multiparae.
KW - Maternal outcome
KW - Nulliparous
KW - Perinatal outcome
KW - Trial of labor
KW - Vaginal breech delivery
UR - http://www.scopus.com/inward/record.url?scp=0031988830&partnerID=8YFLogxK
U2 - 10.1055/s-2007-993906
DO - 10.1055/s-2007-993906
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AN - SCOPUS:0031988830
SN - 0735-1631
VL - 15
SP - 96
EP - 101
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 2
ER -