Effect of mode of delivery on perinatal outcome in breech presentation

Background: breech presentation is most common mal-presentation at term comprising and incidence of 3-4%. there is still considerable controversy in obstetrical management of breech presentation. since late sixties the question of whether a breech should be delivered vaginally or by caesarean section has been discussed with special reference to fetal outcome. breech presentation is associated with increased perinatal mortality and morbidity. aim: to improve perinatal outcome in breech presentation. to find out best mode of delivery for breech presenting fetuses at term. setting: this study was carried at services hospital,lahore duration of study: june 2000 to august 2001. study design: prospective cohort study. sample size: one hundred patients,50 cases of caesarean section group and 50 cases of vaginal delivery group. results: out of 3510 women delivered from june 2000 to august 2001,124 were full term breech deliveries,accounting for an incidence of 3.5%. caesarean section rate was 60% for breech deliveries. fifty cases of c/section and 50 cases of vaginal deliveries were included in the study and results were compared. perinatal mortality in breech babies delivered vaginally was 2% as compared to 0% in c/section. perinatal morbidity was higher in vaginally delivered breech babies but none of them was of serious nature. all of them recovered. maternal complications were slightly higher in c-section groups. conclusion: there is no firm evidence to recommend systemic elective caesarean section for all breech fetuses at term. large unbiased studies are needed to determine whether a potential benefit for the new born out weight the increased risk for mother associated with elective caesarean section.