Delivery in breech presentation: The decision making

Abstract

Objective: To optimize the fetomaternal oucome using different modes of delivery in breech presentation. Materials and Methods: 265 women with different parity and gestational age having singleton breech were studied during Jan 2007 to Sep 2009 at Pt. J.N.M. Medical College and associated Dr. B.R.A.M. Hospital Raipur Chhattisgarh and were assigned to either planned or emergency cesarean section or trial of vaginal delivery after counseling. Fetomaternal outcome was compared in various modes of delivery. Observations: Incidence of breech presentation was 2.1%, prematurity was the most common cause. 113 (42.6%) women delivered vaginally. 54 (20.4%) were planned for cesarean section. Emergency cesarean section was done in 98 (37%). Although perinatal morbidity and mortality was lower in caesarean section group as compared to vaginal delivery group, but the difference became statistically insignificant after adjustment for confounding factors. (p = 0.14) Conclusion In view of insignificant difference in the fetomaternal outcome balanced decision about mode of delivery on a case by case basis will go a long way in improving both foetal and maternal outcome. Regular drill and conduct of vaginal breech delivery should be pursued in all maternity hospitals. © 2012 Federation of Obstetric & Gynecological Societies of India.