Perinatal Outcomes of Vaginal and Abdominal Breech Delivery - A Comparitive Study
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 4
Abstract
Introduction: Neonatal mortality in breech presentation has continued to remain 3- 5 times higher than that of cephalic presentation. The present study was undertaken to achieve expertise in the management of breech deliveries, to standardise and formulate a protocol for selection of patients for vaginal deliveries and to achieve a comparable data for perinatal outcome with elective ceserean deliveries. Material and Methods: In the present study a total number of 2023 cases were observed but only 85 patients having breech delivery were included in the study. If the patient had an adequate pelvis and an average baby weight and there were no high risk factors the patient was selected for vaginal delivery. All patients were delivered by assisted breech delivery. Breech extraction was not necessary in the cases studied. Cesarean section was performed either as elective procedure or after trial of labor. The data was analyzed by comparing the perinatal outcome of breech delivery by vaginal and abdominal. Statistical test used was Test of Significance between Proportions, and p-value was calculated using Z test. Results: Incidence of breech presentation in this study was 4.2% and frank breech was the commonest type of breech. 53% of breech presentation delivered vaginally while 47% underwent Cesarean section. The perinatal mortality rate for vaginal breech delivery was 42/1000. 7 fresh stillbirths were associated with prematurity with other associated complications. 3 fresh stillbirths were due to asphyxia, 1 due to congenital anomalies. 22.2% of the total babies delivered vaginally required neonatal intensive care. Conclusion: Overall perinatal mortality rate was higher in vaginally delivered babies while there was no mortality in cesarean delivered babies. When one minute apgar score in different modes of delivery was studied it was observed that vaginally delivered breech neonates had significantly higher incidence of low apgar score (43.6%) as compared to Cesarean delivered breech neonates (7.5%).
Authors and Affiliations
Shreya Prabhoo, Mohan Gadam
Keywords
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