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Aust N Z J Obstet Gynaecol. 2014 Aug;54(4):333-9. doi: 10.1111/ajo.12208. Epub 2014 Apr 17.

Lessons to be learnt in managing the breech presentation at term: an 11-year single-centre retrospective study.

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1
Department of Obstetrics and Gynaecology, John Hunter Hospital, New Lambton, New South Wales, Australia.

Abstract

BACKGROUND:

The 2000 publication of the Term Breech Trial significantly impacted obstetric practice in Australia with a rapid increase in delivery of term breech singletons by caesarean section. More reassuring data from European centres who continued to offer vaginal breech deliveries to carefully selected women have led to a softening of international guidelines which now support an individualised approach to management. The application of this principle to an Australian population, particularly in the wake of such a major change in obstetric practice, has not previously been demonstrated.

AIM:

To compare short-term neonatal and maternal morbidity for infants with a singleton breech presentation born after 37 weeks, according to planned mode of delivery.

MATERIALS AND METHODS:

Eleven-year single-centre retrospective study with intention-to-treat analysis based on intended mode of delivery.

RESULTS:

Two hundred and forty-three of 766 (31.7%) eligible women elected for planned vaginal breech delivery. The overall success rate in this group was 58%. Morbidity rates were low and compare favourably with similar international studies. However, there was a nonsignificant trend towards higher rates of short-term serious neonatal and maternal morbidity in the planned vaginal delivery group (1.6 vs 0.4%, P = 0.08 and 8.2 vs 4.8%, P = 0.06, respectively).

CONCLUSIONS:

Attempted vaginal delivery for breech presentation remains an option in carefully selected women under strict obstetric protocols.

KEYWORDS:

breech; caesarean section; fetal presentation; obstetric delivery; term

PMID:
24738867
DOI:
10.1111/ajo.12208
[Indexed for MEDLINE]
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