Pregnancy outcome in singleton term breeches from a referral hospital in Saudi Arabia

Abstract

Objective: To compare the pregnancy outcome in women with singleton breech presentation at term delivered by caesarean section (CS) and vaginal breech delivery. Design: A retrospective study Setting: Abha Maternity hospital, Saudi Arabia. Material and Methods: 573 women with singleton breech presentation at term who delivered between January 1994 and December 2000 formed the basis of this study. There were 166 patients (28.9%) who had assisted vaginal breech delivery (AVBD) and 407 patients (71.1%) who were delivered by CS. Results: There were no statistically significant differences in the mean age and number of abortions between the two groups, (p>0.05) but statistically significant differences were found regarding the birth weight and parity respectively (p<0.05). One hundred and fourteen (19.7%) of patients had a previous CS, and of these 2(1.75%) delivered vaginally. Caesarean section was carried out electively in 161 (39.5%) of the 407 who had caesarean delivery. There were no statistically significant differences in the perinatal mortality rates, congenital malformation rates and Apgar score of less than 7 at 5 minutes in babies born by AVBD and CS, (p>0.05). There was statistically significant difference in birth trauma (p<0.00001). Conclusion: Vaginal breech delivery is strongly associated with birth trauma in our community. It is recommended that attention should be given to trainee obstetrician in selective external cephalic version at term and also the procedure of AVBD so as to reduce the caesarean section rate and also neonatal morbidity in term breeches in our community.