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VOLUME 10 , ISSUE 4S1 ( October-December, 2018 ) > List of Articles
Vineeta Gupta, Amrita Makhija, Nidhi Kumari, Rashmi Kumari
Keywords : Breech presentation, Cesarean breech delivery, Vaginal breech delivery
Citation Information : Gupta V, Makhija A, Kumari N, Kumari R. Comparative Study of Vaginal and Cesarean Section Delivery for Fetuses in Breech Presentation. J South Asian Feder Obs Gynae 2018; 10 (4S1):321-327.
License: CC BY-NC 4.0
Published Online: 01-01-2018
Copyright Statement: Copyright © 2018; The Author(s).
Objective: The present retrospective study was carried out to compare the maternal and fetal outcome in patients with breech presentation who delivered vaginally versus who delivered by cesarean section. The study also provided us with an opportunity to analyze the demographic and clinical profile between the two groups. Materials and methods: The study was conducted in the Obstetrics Unit of Shri Guru Ram Rai Institute of Medical and Health Sciences and Shri Mahant Indiresh Hospital, Dehradun throughout 2 years. All patients admitted to the labor room with a singleton fetus in breech were included in the present study. All the patients were studied for their demographic profile, parity, gestational age, high-risk factors, mode of delivery, an indication of cesarean delivery and neonatal outcome. Maternal and neonatal outcome was compared between the patients who delivered vaginally versus who delivered by cesarean section using standard statistical methods. Results: A total of 266 patients with breech presentation were included in the study, of which 95 (35.71%) were delivered vaginally, 118 (44.36%) underwent emergency cesarean section and 53 (19.92%) had an elective cesarean section. Out of 266, 145 (54.51%) women were nulliparous and 121 (45.49%) were multiparous. Both emergency and elective cesarean rates were more frequent in nulliparous women. The average period of gestation increased from 34.03 ± 4.04 weeks in the vaginal breech delivery group to 37.71 ± 2.48 weeks in the emergency cesarean group and 39.17 ± 0.92 weeks in the elective cesarean group. The most common indication for emergency cesarean delivery was refusal for the trial of vaginal delivery present in 52.54% and elective cesarean delivery it was primigravida with the breach in 47.17%. The average birth weight of vaginally delivered babies was 1.819 ± 0.70 kg, for those delivered by emergency cesarean section it was 2.540 ± 0.66 kg and for those delivered by elective cesarean section it was 2.942 ± 0.50 kg. A total of 218 Apgar scores were compared excluding 37 patients who presented with IUD, 9 stillbirths and 2 patients with gross congenital malformations. It was noted that 65.38% of vaginally delivered babies had Apgar score of more than 7 at 5 minutes of birth as compared to 87.61% of babies delivered by emergency cesarean section and 100% of babies delivered by elective cesarean section. Overall 85.32% of babies had Apgar score more than 7 at 5 minutes of birth. There was no maternal mortality and no significant maternal morbidity in the different groups. Conclusion: The present study concludes that planned vaginal delivery of both preterm and term breech in a carefully selected patient can be conducted after proper counseling of the patient with strict intrapartum monitoring and presence of obstetricians trained in the art of conducting breech deliveries.