Management trend and safety of vaginal delivery for term breech fetuses in a tertiary care hospital of Karachi, Pakistan

Journal of Perinatal Medicine
N B MohammedS Luby

Abstract

To investigate the safety of vaginal delivery for term breech fetuses in a tertiary-care hospital of Pakistan. We reviewed the medical records of all live singleton breech deliveries at or beyond 37 weeks of gestation, at the Aga Khan University Hospital, Karachi, from January 1988 to December 1995. Rate of cesarean section increased from 48% (1988) to 74% (1995). Out of 287 subjects, 158 underwent elective cesarean section while 129 received a trial of labor, 77% of which delivered vaginally. There was no neonatal or maternal death. Compared to babies delivered by emergency or elective cesarean section, those delivered vaginally had significantly more neonatal intensive-care unit admissions (none and 5% versus 13%) and higher rates of birth trauma (none and 0.6% versus 7%). However, there was no significant difference in the Apgar score at 5 minutes and the risk of maternal complications by delivery mode. Allowing trial of labor to carefully selected mothers can result in vaginal delivery in 77% of the cases. However, the risk of trauma and neonatal intensive-care unit admissions, among vaginal births may favor the decision of elective cesarean section, unless rigorous pre-delivery assessment and conduct of delivery by adequat...Continue Reading

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Citations

Oct 2, 2013·Journal of Obstetrics and Gynaecology of India·Elie NkwabongPius Chanchu Ngassa
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Related Concepts

Birth Injuries
Incomplete Breech Presentation
Postcesarean Section
Hospitals, University
Postneonatal Mortality
Maternal Mortality
Obstetric Delivery

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