Skip Navigation, or press ALT and K together and then press enter.Welcome to the OMC website. This site has been developed for both the visually impaired and non visually impaired. If you would like to use the visually impaired version of this site please go to omc.gov.ie/viewtxt.asp, or press ALT and I together and then press enter

Irish Child Health Database - Peer Reviewed Papers

Database Search


You are here: Irish Child Health Database » Study Papers » Descriptive Studies - Without a comparision » Case Series Study
  • Singleton vaginal breech delivery at term: still a safe option

    Published in:

    Obstet Gynecol, Vol: 103, Page: 407-12

    Publication Date:

    March 2004

    Aims & Objectives:

    This study examined the obstetric and perinatal outcome of pregnancies with singleton breech presentation at term when selection for vaginal delivery was based on clear prelabor and intrapartum criteria

    Abstract:

    OBJECTIVE: To examine the obstetric and perinatal outcome of pregnancies with singleton breech presentation at term when selection for vaginal delivery was based on clear prelabor and intrapartum criteria. METHODS: The outcomes of all pregnancies with a breech presentation after 37 weeks of gestation were retrospectively reviewed from January 1997 to June 2000. Criteria for prelabor cesarean or trial of vaginal breech delivery included type of breech, estimated fetal weight (more than 3,800 g), maternal preference, and gestation more than 41 weeks. An intrapartum protocol excluded induction and oxytocin augmentation of labor, combined with a low threshold for cesarean delivery for dystocic labor; an experienced obstetrician was in attendance during labor and delivery. RESULTS: Of 641 women, 343 (54%) underwent prelabor cesarean, and 298 (46%) had a trial of vaginal delivery, of whom 146 (49%) delivered vaginally. Significantly fewer nulliparas (58 of 158, 37%) than multiparas (88 of 140, 63%; P <.001) achieved vaginal delivery after trial of labor. Significantly more infants weighing more than 3,800 g were selected for prelabor (87 of 343, 25%) and intrapartum (31 of 152, 20%) cesarean than delivered vaginally (15 of 146, 10%). Two neonates (0.7%) had Apgar scores of less than 7 at 5 minutes; both were neurologically normal at 6 weeks. There were no nonanomalous perinatal deaths and no cases of significant trauma or neurological dysfunction; 3 infants delivered vaginally died due to lethal anomalies. CONCLUSION: Safe vaginal breech delivery at term can be achieved with strict selection criteria, adherence to a careful intrapartum protocol, and with an experienced obstetrician in attendance. Our protocol effectively selects larger infants for cesarean delivery. LEVEL OF EVIDENCE: II-2

    Authors:

    M. Alarab; C. Regan; M. P. O'Connell; D. P. Keane; C. O'Herlihy; M. E. Foley

    Study Type:

    Study Papers » Case Series Study » Descriptive Studies - Without a comparision

    Categories:

    outcome of pregnancies with singleton breech presentation at term

    International Classification:

    Pregnancy, childbirth and the puerperium - outcome of pregnancies with singleton breech presentation at term

    Keywords:


    Geography:

    Republic of Ireland (Dublin)