Planned vaginal delivery versus caesarean section for breech presentation in Ile-Ife, Nigeria

Abstract

Background: The optimum mode of breech delivery remains a matter of controversy among obstetricians worldwide. Objective: To determine whether term breech babies born by planned vaginal delivery are at higher risk of neonatal mortality and morbidity than those born by planned caesarean delivery. Design: A hospital based non-experimental comparison of outcome of breech delivery. Setting: Ife State Hospitals Complex, Ile-Ife. Subjects: Two hundred and fourty four singleton breech deliveries occurring at term. Main outcome measures: They include low 5-minute Apgar score, birth trauma, maternal and perinatal morbidity and mortality. Results: The perinatal mortality was not significantly different in both groups: OR 2.7 (95% C.I. 0.3-26.8). The low 5-minute Apgar scores were higher in the planned vaginal delivery OR 9.0 (95% C.I. 1-73.4), but the traumatic morbidity was not (OR 1.8, 95% C.I. 0.2-20.1). Maternal morbidity occurred more in the planned Caesarean delivery group OR 0.4 (95% C.I. 0.2-0.9). Conclusion: Given appropriate selection criteria and management protocol, the outcome from elective caesarean section might not be better than from planned vaginal delivery.