Vaginal Breech Delivery; Still a Safe Mode of Delivery to Reduce the Rate of Cesarean Section

.. Objective: To determine the obstetric and perinatal outcome of pregnancies with singleton breech presentation, and to scrutinize the causes of increasing incidence of cesarean section in breech presentation. Design: Analytical Observational study. Place and duration: Department of obstetrics and gynecology Fatima hospital Baqai university campus from Jan 2010 to Oct 2011. Patients & Methods: This study includes 135 patients with singleton breech presentation ≥ 34 weeks of gestation, were analyzed in detail with help of designed performa. Patients were categorized in three groups. Groups a, who had elective C-section, group b. who underwent emergency caesarean section or had C-section after failed trial of vaginal delivery and group c. who had vaginal breech delivery. Elective caesarean section was done in those cases that had some other indications for carrying out this procedure apart from breech presentation. Trial of vaginal breech delivery was planned for all multiparous women except those falling in group A. All antepartum fetal demise, twin pregnancies and placenta previa of major degree were excluded. Results: Of 135 women, 7(5%) underwent prelabour cesarean, and 128(95%), had trial of vaginal delivery, of whom 117(91.5%) delivered vaginally. Significantly more infants weighing> 3.5kg were selected for prelabour and intrapartum cesarean than vaginal delivery. Two neonates had Apgar score< 7 at 5 minutes but both were normal neurologically. There were no nonanomalous perinatal death and no case of significant trauma or neurological dysfunction. Two infants died due to lethal anomalies. Conclusion: Trial of vaginal breech delivery in well counselled patients, still taken as an appropriate option without compromising prenatal and maternal outcome. It also decreases the rate of cesarean section.