Pregnancy outcomes by mode of delivery among breech births.

OBJECTIVE

To compare maternal and neonatal outcomes of the vaginal delivery versus cesarean delivery for the breech presentation.

METHODS

We reviewed the maternal and neonatal charts of all singleton breech deliveries of <1,000, 1,000-1,500, 1,501-2,500, 2,501-4,000, and >4,000 g delivered between 2000 and 2006 at our institution. The study population consisted of 1,537 women with a fetus in a breech presentation. A group of 478 women that had delivered vaginally was compared with a group of 1,059 women, who had cesarean delivery, regarding neonatal mortality and morbidity (asphyxia, bone fractures, intraventricular hemorrhage, convulsions, respiratory distress syndrome, necrotizing enterocolitis, congenital hip dislocation), and maternal morbidity (febrile morbidity, anemia, wound infection).

RESULTS

Neonatal complications did not differ between the group of women with term babies, <1,000 g babies, >1,500 g babies in breech presentation for women that had vaginal delivery and those that had cesarean delivery. On the other hand, breech presentation in preterm delivery between 1,000 and 1,500 g birth weight appears an independent risk factor for the neonatal mortality. There were fewer maternal complications in the vaginal group than in the cesarean group.

CONCLUSIONS

Vaginal delivery of 1,000-1,500 g babies presenting as breech is associated with the increased neonatal mortality compared with cesarean delivery. Cesarean delivery is associated with maternal morbidity compared with the vaginal delivery.