Document Detail


Outcome of term breech births: 10-year experience at a district general hospital.
MedLine Citation:
PMID:  15663587     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the short and long term outcomes among singleton infants with breech presentation at term delivered in a geographically defined population over a 10-year period. DESIGN: Retrospective, cohort study. SETTING: District General Hospital. POPULATION: 1433 term breech infants alive at the onset of labour and born between January 1991 and December 2000. METHODS: Data abstracted from birth registers, neonatal discharge summaries and the child health database system were used to compare the short and long term outcomes of singleton term breech infants born by two different modes of delivery (prelabour caesarean section and vaginal or caesarean section in labour). Fisher's exact test was used to compare the categorical variables. MAIN OUTCOME MEASURES: Short term outcomes: perinatal mortality, Apgar scores, admission to the neonatal unit, birth trauma and neonatal convulsions. Long term outcomes: deaths during infancy, cerebral palsy, long term morbidity (development of special needs and special educational needs). RESULTS: Of 1433 singleton term infants in breech presentation at onset of labour, 881 (61.5%) were delivered vaginally or by caesarean section in labour and 552 (38.5%) were born by prelabour caesarean section. There were three (0.3%) non-malformed perinatal deaths among infants born by vaginal delivery or caesarean section in labour compared with none in the prelabour caesarean section cohort. Compared with infants born by prelabour caesarean section, those delivered vaginally or by caesarean section in labour were significantly more likely to have low 5-minute Apgar scores (0.9% vs 5.9%, P < 0.0001) and require admission to the neonatal unit (1.6% vs 4%, P= 0.0119). However, there was no significant difference in the long term morbidity between the two groups (5.3% in the vaginal/caesarean section in labour group vs 3.8% in the prelabour caesarean group, P= 0.26); no difference in rates of cerebral palsy; and none of the eight infant deaths were related to the mode of delivery. CONCLUSIONS: Vaginal breech delivery or caesarean section in labour was associated with a small but unequivocal increase in the short term mortality and morbidity. However, the long term outcome was not influenced by the mode of delivery.
Authors:
Poonam Pradhan; Michele Mohajer; Sanjeev Deshpande
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  112     ISSN:  1470-0328     ISO Abbreviation:  BJOG     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-24     Completed Date:  2005-02-17     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  218-22     Citation Subset:  AIM; IM    
Affiliation:
Heartlands and Solihull NHS Trust, Princess of Wales Maternity Unit, Birmingham B9 5SS, UK.
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MeSH Terms
Descriptor/Qualifier:
Breech Presentation*
Cohort Studies
Delivery, Obstetric / statistics & numerical data
England / epidemiology
Female
Hospitals, District / statistics & numerical data
Hospitals, General / statistics & numerical data
Humans
Obstetric Labor, Premature / epidemiology
Pregnancy
Pregnancy Outcome / epidemiology*
Retrospective Studies

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