Clinical Study of the Mode of Delivery and Perinatal Outcome in Breech Delivery

To evaluate the outcome of the deliveries in breech presentation at labor and to compare the results by the route of delivery.

Prospective study of randomised cases of 100 singleton pregnancies with breech presentation attending the teaching hospitals attached to JJM Medical College, Davangere. All primi and multigravida with singleton breech presentation with more than 28 weeks of gestation with the estimated fetal weight of more than 1.5kg and less than 3.5kg were considered. Mode of delivery and perinatal outcome were studies.

Out of 100 cases, 46 delivered vaginally and 56 were delivered by cesarian section. The perinatal outcome was good in LSCS than vaginal delivery. Perinatal mortality was seen only in assisted breech delivery with an incidence of 4.5%. Perinatal loss was observed more in the birth weight of 2.5 to 3.5kg with an incidence of 6%.

In our study it was clearly observed that there was zero perinatal mortality considering both elective and emergency cesarean sectionwhen compared to vaginal breech delivery, more specifically risk is lowest with prelabor cesarean or during early labor. It was also noted that vaginal breech delivery in multiparous women had good perinatal outcome than in primiparous women. But there are suggestions that with active involvement of experienced obstetricians and applying appropriate management protocol vaginal breech delivery can achieve comparable safety for the infant with a cesarean section. There is still a place for vaginal breech delivery in selected cases of breech presentation more so in multiparous women