Title: For A Singleton Breech Presentation Vaginal Delivery Should Be an Option A Review Over One Year in A Tertiary Hospital
Authors: Dr Anees Aisha, Dr Jagadevi
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.187
Abstract
Introduction: Breech is commonest malpresentation, with incidence ranging from 3 to 4% in term gestations. Perinatal mortality is increased 2-4 fold with breech presentation regardless of mode of delivery. Offering a trial of vaginal breech delivery to a well counselled strictly selected patients remains an appropriate option.
Aims and Objectives
1. To study the maternal complications like genital tract trauma after term breech delivered vaginally.
2. To study the neonatal complications in terms of perinatal mortality, apgar score at 5 minutes, and neonatal trauma in all singleton term breech delivered vaginally.
Material and Methods: Hundred patients with singleton term breech presentation delivered vaginally during the year 2015, were studied retrospectively, for maternal and neonatal complications. maternal complications include genital tract trauma and neonatal complications include perinatal mortality, apgar score at 5 minutes, and neonatal trauma
Results: Hundred patients with singleton term breech presentation admitted and delivered vaginally were studied retrospectively. All were unbooked cases in labour. 90% were multigravidae and 10 % were primigravidae. An apgar score of >\=8 at 5 minutes was observed in 91% of cases while 4% had apgar score <8 at 5 minutes. there were 5 still births and 2 neonatal deaths. None of the baby had birth trauma. Only 2% of mothers had genital tract trauma (cervical tears).
Conclusion: Offering a trial of vaginal breech delivery to selected and well counselled women is an appropriate option without compromising perinatal and maternal outcome. Thus contributing in decreasing the rising caesarean section rate.
References
1. Abasiattai AM, Etuk SJ, Asuquo EJ, Ikiaki CO. Perinatal outcome following singleton vaginal breech delivery in the University of Calabar Teaching Hospital, Calabar. A 10-year review. Mary Slessor J Med 2004;4:81-5.
2. Fasubaa OB, Kuti O, Orji EO Ogunlola O, Shittu S. Outcome of singleton breech delivery in Wesley Guild Hospital Ilesha Nigeria. Trop J Obstet Gynaecol 2003;20:59-62.
3. Shittu SA, Fasubaa OB, Dare FO, Ogunniyi OS. Five year review of breech presentation at Ile-Ife Nigeria. Trop J Obstet Gynaecol 2001;18:36.
4. Tunau K, Ahmed Y. Breech deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto, Northwestern Nigeria: A 10-year review. Sahel Med J 2013;16:52-5.
5. Aisien AO, Lawson O. Outcome of term singleton breech deliveries in a tertiary health care centre. Trop . Obstet Gynaecol 2003;20:121-33.
6. Fawole A, Adeyemi AS, Adewole IF, Omigbodun AO. A Ten year review of breech deliveries in Ibadan. Afri J Med Sci 2001;30 87-90.
7. Gutgutia I, Gupta M, Das B. Vaginal delivery for breech presentation should be an option: experience in a tertiary care hospital. Int J Reprod Contracept Obstet Gynecol 2014;3:562-5.
8. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 340. Mode of term singleton breech delivery. Obstet Gynaecol. 2006;108(1): 235-7.
9. Royal College of Obstetricians and Gynaecologists. The management of breech presentation. In RCOG, eds. RCOG Green Top Guidelines. Guideline no. 20b. London: RCOG; 2006: 1-13.
10. Kotaska A, Menticoglou S, Gagnon R, The Maternal-Fetal Medicine Committee of the Society of Obstetricians and Gynaeco-logists of Canada. Vaginal delivery of breech presentation. SOGC Clinical Practice Guideline No. 226, June 2009. J Obstet Gynaecol Can. 2009;31:557-66.
11. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet. 2000;356(9239):1375–83.
12. Levine MG, Holroyde J, Woods JR Jr, Siddiqi TA, Scott M, Miodovnik M. Birth trauma: incidence and predisposing factors. Obstet Gynecol 1984;63:792–5.
13. Iffy L, Varadi V, Papp Z. Epidemiologic aspects of shoulder dystociarelated neurological birth injuries. Arch Gynecol Obstet 2015;291:769–77.
14. Berhan Y, Kassie A. Extracranial hemorrhage in babies admitted to neonatal unit over a 10-year period. Ethiop J Health Dev 2004;18:190–8.
15. Hankins GD, Clark SM, Munn MB. Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise. Semin Perinatal 2006;30: 276–87.
16. Y Berhan,a A Haileamlakb The risks of planned vaginal breech delivery versus planned caesarean section for termbreech birth: a meta-analysis including observa-tional studies Accepted 19 May 2015. Published Online 29 July 2015.