scholarly journals Comparative study of perinatal outcome between abdominal and vaginal route of delivery in case of breech presentation

2018 ◽  
Vol 7 (9) ◽  
pp. 3758
Author(s):  
Gourav Ranjan Tripathy ◽  
M. Smitha ◽  
Anand Acharya
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Vaginal Route ◽  
Breech Delivery ◽  
Labour Room ◽  
Route Of Delivery

Background: Breech presentation is also one of the most interesting subjects in obstetrics as no other malpresentation has so many manoeuvres during vaginal delivery and their impact on perinatal mortality. The mode of delivery also depends on so many variables like parity, type of breech presentation, associated obstetric complications, estimated birth weight etc and also from obstetrician point of view.Methods: Pregnant mother with breech presentation of gestational age 32 weeks or more were included in this study. Multiple pregnancy with first baby in breech presentation were excluded from this study. New born baby with gross congenital anomalies like anencephaly, omphalocele were excluded from this study. The cases for present study were collected from antenatal OPD, labour room, High-risk ward and Post-natal ward of KIMS & RF from June 2016 to December 2017.Results: Out of 61 cases of caesarean section there were 4 cases (6.55%) of neonatal death. PNM among the 100 cases was 4% in caesarean section. In 32 assisted breech delivery cases there were 8 cases (25%) of perinatal death. PNM among the 100 cases was 8% in assisted breech delivery. Out of 4 cases of breech extractions there were 3 cases (75%) of perinatal death. PNM among the 100 cases was 3% in breech extraction.Conclusions: Present study suggests that breech delivery should preferably be always managed in the hospital by skilled and experienced obstetrician with an assistant in collaboration with a pediatrician and an anesthetist. As good numbers of babies were premature a good premature care unit should be pre-managed under the supervision of a pediatrician.

scholarly journals Breech Presentation Among Nullipara at Term: An Indication for Caesarean Section

2014 ◽  
Vol 10 (4) ◽  
pp. 66-69
Author(s):  
A Dongol ◽  
S Regmi ◽  
S Manandhar ◽  
S KC
Keyword(s):  
Caesarean Section ◽  
Analytical Study ◽  
Post Partum ◽  
Elective Caesarean Section ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
University Hospital ◽  
Breech Delivery ◽  
Maternal Morbidity And Mortality ◽  
Route Of Delivery

Background Breech is the commonest malpresentation. Vaginal breech delivery in a nulliparous lady carries higher risk than in multiparous ladies. Poor neonatal outcome following vaginal delivery has made the mode of delivery a matter of controversy. Objective To evaluate the outcome of planned caesarean section among nullipara ladies with breech presentation. Method This is a prospective, analytical study conducted in Dhulikhel Hospital Kathmandu University Hospital from January 2008 to June 2012 among 102 nullipara ladies at term gestation with breech presentation. All cases underwent caesarean section either elective or emergency. During section cause of breech presentation was searched for. Neonatal condition was evaluated using APGAR Score, need for resuscitation and admission in NICU. Post partum status was also recorded for evaluation of maternal morbidity and mortality. Results These Nullipara ladies often had some reason for breech presentation, the most common being cord around the neck. Perinatal outcome was uneventful in 97(95%) neonates, there were two (2%) still birth and three (3%) needed NICU care. APGAR was good in 92 neonates, average in eight and poor in two. Total 16(15.6%) ladies stayed hospital for more than eight days. Among them 11(10.7%) developed wound infection and five stayed in hospital waiting for baby. Conclusion Nullipara ladies with breech presentation should have elective caesarean section as a preferred route of delivery. DOI: http://dx.doi.org/10.3126/kumj.v10i4.10998 Kathmandu Univ Med J 2012;10(4):66-69

scholarly journals Outcome of breech delivery: caesarean section versus vaginal delivery at Patan Hospital, Patan Academy of Health Sciences

2016 ◽  
Vol 3 (1) ◽  
pp. 4-9 ◽  
Author(s):  
Anagha Pradhan Malla ◽  
Laxmi RC ◽  
Alka Singh ◽  
Reena Shrestha ◽  
Padma Gurung ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Maternal Blood ◽  
Health Sciences ◽  
Term Infant ◽  
Critical Element ◽  
Intrauterine Death ◽  
Breech Delivery ◽  
Vaginal Breech Delivery

Introductions: Obstetricians have long debated the role of caesarean section as a potentially safer mode of delivery for the fetus with breech presentation. However, the experience of the health care provider remains a critical element in the decision to pursue a vaginal breech delivery, and it may still be a viable option. The aim of this study is to determine the incidence of breech delivery at Patan Hospital and compare maternal and neonatal outcomes subjected to either vaginal or caesarean section.Methods: This was a five-year retrospective study of breech deliveries covering the year 2010 to 2014. Patient’s charts were retrieved from the medical record section and reviewed.Results: There were 896 breech deliveries out of a total 44,842 deliveries giving an incidence of 1.99%. One hundred thirteen (12.61%) of breech deliveries were through vaginal route while 431 (48.10%) and 352 (39.28%) were through emergency and elective caesarean sections respectively. There were 154 (17.18%) preterm breech deliveries including 27 (17.5%) preterm intrauterine death. Among term pregnancy, there were 3 neonatal deaths not associated with mode of delivery. None of the term infant had neurological morbidity comprising neonatal seizures, brachial plexus injury, chephalohematoma. Maternal blood loss was significantly higher in caesarean section group. Conclusions: In well-selected cases, the neonatal outcome following assisted vaginal breech delivery and caesarean section may not be different.Journal of Patan Academy of Health Sciences, Vol. 3, No. 1, 2016. page: 4-9

scholarly journals Study of fetomaternal outcome in various modes of breech delivery in a tertiary care hospital- MGM GH, Trichy

2020 ◽  
Vol 10 (1) ◽  
pp. 154
Author(s):  
Uma Mohanraj ◽  
A. Adhirai
Keyword(s):  
Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Care Hospital ◽  
Breech Delivery ◽  
Medical College ◽  
Maternity Hospitals ◽  
Insignificant Difference ◽  
Case Basis

Background: Aim of the study was to optimize the fetomaternal outcome using different modes of delivery in breech presentation and objective of the study was to optimize the maternal and perinatal outcome in various modes of breech delivery.Methods: Among 150 mothers with different parity and gestational age having singleton breech were studied during May 2019- October 2019 for the period of 6 months at KAPV government medical college. Fetomaternal outcome was compared in various modes of breech delivery during this study period in our institute. This study was a prospective analytical study.Results: Incidence of breech presentation was 3.3% of total deliveries in this institute. Around 4 (26.6%) cases by emergency LSCS, 48 (32%) cases delivered vaginally, 62 (41.3%) cases by elective LSCS. Comparatively, large number of cases were delivered by planned caesarean section in our institute. The maternal and perinatal morbidity and mortality was found to be less in planned caesarean section compared with other modes of delivery in this study.Conclusions: In view of insignificant difference in the fetomaternal outcome balanced decision about mode of delivery on a case by case basis will go a long way in improving both fetal and maternal outcome. Regular drills and conduct of assisted vaginal breech delivery should be pursued in all maternity hospitals.

scholarly journals Perinatal Outcome of Vaginal Breech Delivery versus Caesarean Breech Delivery in a Tertiary Care Center

2018 ◽  
Vol 56 (212) ◽  
pp. 796-799 ◽  
Author(s):  
Rajendra Kumar Chaudhary ◽  
Rajan Ghimire ◽  
Deepak Raj Kafle
Keyword(s):  
Perinatal Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Study Data ◽  
Perinatal Morbidity ◽  
Vaginal Route ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Significant Odds Ratio

Introduction: Breech delivery has always been matter of interest in obstetrics. Cesarean breech delivery has been preferred method of delivery. We aim to find out any differences in outcome between vaginal breech delivery and cesarean breech delivery in our setup. Methods: Data were collected from record book of Department of Gynaecology and obstetrics, Pokhara Academy of Health Sciences, Kaski, Nepal. Pregnant with breech presentation who had delivery in the centre from 2074 Baishak to 2074 chaitra were enrolled in the study. Data of 174 patients were analysed among which 74 underwent vaginal delivery for breech and 110 underwent cesarean breech delivery. Results: Only 1 (1.6%) of newborn delivered by vaginal route were admitted to NCU vs 17 (15.5% )in cesarean group which was significant (odds ratio= 0.071, 95% C.I 0.009-0.574; p= 0.004). There was only one death of newborn which was delivered by vaginal route. Mean APGAR score at 1 and 5 minute in vaginal breech delivery was 6 and 7 and in cesarean breech delivery was 6 and 8. Conclusions: Though perinatal morbidity was more with cesarean breech delivery but further study with more sample size is needed before reaching conclusion.

scholarly journals VAGINAL BREECH DELIVERY

2015 ◽  
Vol 22 (08) ◽  
pp. 1024-1028
Author(s):  
Samina Naz
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Death ◽  
Elective Caesarean Section ◽  
Breech Presentation ◽  
Neurological Dysfunction ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Group A ◽  
Group B

Objective: To determine the obstetric and perinatal outcome of pregnancieswith singleton breech presentation, and to scrutinize the causes of increasing incidence ofcesarean section in breech presentation. Design: Analytical Observational study. Place andduration: Department of obstetrics and gynecology Fatima hospital Baqai university campusfrom Jan 2010 to Oct 2011. Patients & Methods: This study includes 135 patients with singletonbreech presentation ≥ 34 weeks of gestation, were analyzed in detail with help of designedperforma. Patients were categorized in three groups. Groups a, who had elective C-section,group b. who underwent emergency caesarean section or had C-section after failed trial ofvaginal delivery and group c. who had vaginal breech delivery. Elective caesarean section wasdone in those cases that had some other indications for carrying out this procedure apart frombreech presentation. Trial of vaginal breech delivery was planned for all multiparous womenexcept those falling in group A. All antepartum fetal demise, twin pregnancies and placentaprevia of major degree were excluded. Results: Of 135 women, 7(5%) underwent prelabourcesarean, and 128(95%), had trial of vaginal delivery, of whom 117(91.5%) delivered vaginally.Significantly more infants weighing> 3.5kg were selected for prelabour and intrapartumcesarean than vaginal delivery. Two neonates had Apgar score< 7 at 5 minutes but both werenormal neurologically. There were no nonanomalous perinatal death and no case of significanttrauma or neurological dysfunction. Two infants died due to lethal anomalies. Conclusion:Trial of vaginal breech delivery in well counselled patients, still taken as an appropriate optionwithout compromising prenatal and maternal outcome. It also decreases the rate of cesareansection.

Assessment Of Perinatal Outcome Of Breech Presentation At A Tertiary Care Hospital, Quetta

2019 ◽  
Vol 09 (03) ◽  
pp. 218-221
Author(s):  
Safia Bibi ◽  
Khanda Gul ◽  
Fozia Mohammad Bukhsh ◽  
Palwasha Gul
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Analytical Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Care Hospital ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Clinical Records

Objective: To review the mode of delivery and perinatal outcome in breech presentation in a tertiary care hospital. Study Design and Setting: Retrospective Analytical Study. Department of Obstetrics and Gynecology Unit-4, Bolan Medical Complex Hospital, Quetta, from 1st January 2012 to 31st December, 2016. Methodology: This retrospective analytical study included review of clinical records of all patients who delivered either vaginally or via caesarean section with breech presentation. Results: During the study period, 806 patients presented with breech (2.4%). Vaginal breech delivery was carried out in 71.8% patients and caesarean section was done in 28.2% patients. In vaginal breech group 30.7% patients were primigravida and 69.3% patients were multigravida. In caesarean section group 50.3% patients were primigravida and 49.7% were multigravida. Most common birth weight was between 2.5-3.5 kg in both group. Most common indication for cesarean section was breech with previous one LSCS. Conclusion: Like all vaginal births, vaginal breech delivery is not only beneficial in the chance of having a vaginal birth in future but also prevents from the complications of caesarean delivery.

scholarly journals Fetomaternal outcome in breech delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2480
Author(s):  
Bhavesh B. Airao ◽  
Vishal M. Sharma ◽  
Ravi A. Zala ◽  
Vimal Vasava
Keyword(s):  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Mortality And Morbidity ◽  
Breech Delivery ◽  
Different Types

Background: Breech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. The objectives of the present study are to know the common causes leading to breech presentation. Further, to compare the different management protocols and outcome in different types of breech presentation.  Also, to know the perinatal morbidity and mortality associated with different types of breech presentation nd comparison of perinatal morbidity and mortality with vaginal delivery against cesarean section.Methods: This is a retrospective study of randomized 100 cases of pregnant women in labour with breech presentations after 28 weeks or more attending C U Shah Medical College, Surendranagar, over a period of May 2012 to April 2014.Results: Out of 100 patients breech presentation was more common in booked patients and multigravida. In primi and multigravidae patients, caesarean delivery was more compared to assisted breech delivery. Perinatal outcome was good in majority of the patients in both extended and complete breech with an incidence of 94% and 88% respectively. perinatal outcome was good in caesarean section with 100% compared to assisted breech delivery 93%.Conclusions: The balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation like ours. Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality.

scholarly journals MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva
Keyword(s):  
Caesarean Section ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.

scholarly journals Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

2019 ◽  
Vol 31 (1) ◽  
pp. 23-26
Author(s):  
Mahe Jabeen ◽  
Sabiha Shimul ◽  
Ummay Salma ◽  
Jebunnesa
Keyword(s):  
Caesarean Section ◽  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Neonatal Outcome ◽  
Elective Caesarean Section ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Cost Of Care ◽  
Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

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