Mode of delivery in breech presentation at term: increased neonatal morbidity with vaginal delivery
(2001) In Acta Obstetricia et Gynecologica Scandinavica 80(8). p.731-737- Abstract
- OBJECTIVE: To compare the neonatal outcome in planned vaginal delivery and planned cesarean section in term singleton pregnancies with breech presentation in a Scandinavian clinic with a high rate of vaginal breech delivery. METHODS: A retrospective study including 1050 term singleton breech pregnancies delivered at a Swedish tertiary referral center during 1988 to 2000. For 699 patients (67%) a vaginal delivery was planned, of whom 603 (86%) were delivered vaginally. In 327 (31%) cases a cesarean section was planned and performed. These two groups were compared regarding rates of acidemia at birth (cord artery pH <7.05), low Apgar scores and neonatal neurological morbidity. Long term sequels among infants with a complicated neonatal... (More)
- OBJECTIVE: To compare the neonatal outcome in planned vaginal delivery and planned cesarean section in term singleton pregnancies with breech presentation in a Scandinavian clinic with a high rate of vaginal breech delivery. METHODS: A retrospective study including 1050 term singleton breech pregnancies delivered at a Swedish tertiary referral center during 1988 to 2000. For 699 patients (67%) a vaginal delivery was planned, of whom 603 (86%) were delivered vaginally. In 327 (31%) cases a cesarean section was planned and performed. These two groups were compared regarding rates of acidemia at birth (cord artery pH <7.05), low Apgar scores and neonatal neurological morbidity. Long term sequels among infants with a complicated neonatal course were also identified. RESULTS: Acidemia at birth, Apgar score below 7 at 5 minutes, and referral to neonatal intensive care unit all occurred at higher rates in planned vaginal delivery (5.3%, 3.6%, and 8.9%, respectively), than in planned cesarean delivery (0, 0, and 4.0%). The rate of neonatal neurological morbidity was 24/699 (3.4%) in planned vaginal delivery (18 cases with cerebral symptoms and six cases of brachial plexus palsy) compared to one case (cerebral symptoms) after a planned cesarean. These differences were all statistically significant (p< or =0.002). Of the neurologically affected neonates, two died and four had cerebral palsy (one delivered by planned cesarean section) at follow up. CONCLUSION: Neonatal morbidity may be reduced with planned cesarean delivery in breech presentation, also in a Scandinavian setting. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1120612
- author
- Herbst, Andreas LU and Thorngren-Jerneck, Kristina LU
- organization
- publishing date
- 2001
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- breech presentation, cesarean section, neonatal morbidity, vaginal delivery
- in
- Acta Obstetricia et Gynecologica Scandinavica
- volume
- 80
- issue
- 8
- pages
- 731 - 737
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:11531616
- scopus:0034870705
- ISSN
- 1600-0412
- DOI
- 10.1034/j.1600-0412.2001.080008731.x
- language
- English
- LU publication?
- yes
- id
- d21a762d-788b-442e-b9b5-e4ed2bc20e92 (old id 1120612)
- date added to LUP
- 2016-04-01 16:59:45
- date last changed
- 2022-04-07 20:09:58
@article{d21a762d-788b-442e-b9b5-e4ed2bc20e92, abstract = {{OBJECTIVE: To compare the neonatal outcome in planned vaginal delivery and planned cesarean section in term singleton pregnancies with breech presentation in a Scandinavian clinic with a high rate of vaginal breech delivery. METHODS: A retrospective study including 1050 term singleton breech pregnancies delivered at a Swedish tertiary referral center during 1988 to 2000. For 699 patients (67%) a vaginal delivery was planned, of whom 603 (86%) were delivered vaginally. In 327 (31%) cases a cesarean section was planned and performed. These two groups were compared regarding rates of acidemia at birth (cord artery pH <7.05), low Apgar scores and neonatal neurological morbidity. Long term sequels among infants with a complicated neonatal course were also identified. RESULTS: Acidemia at birth, Apgar score below 7 at 5 minutes, and referral to neonatal intensive care unit all occurred at higher rates in planned vaginal delivery (5.3%, 3.6%, and 8.9%, respectively), than in planned cesarean delivery (0, 0, and 4.0%). The rate of neonatal neurological morbidity was 24/699 (3.4%) in planned vaginal delivery (18 cases with cerebral symptoms and six cases of brachial plexus palsy) compared to one case (cerebral symptoms) after a planned cesarean. These differences were all statistically significant (p< or =0.002). Of the neurologically affected neonates, two died and four had cerebral palsy (one delivered by planned cesarean section) at follow up. CONCLUSION: Neonatal morbidity may be reduced with planned cesarean delivery in breech presentation, also in a Scandinavian setting.}}, author = {{Herbst, Andreas and Thorngren-Jerneck, Kristina}}, issn = {{1600-0412}}, keywords = {{breech presentation; cesarean section; neonatal morbidity; vaginal delivery}}, language = {{eng}}, number = {{8}}, pages = {{731--737}}, publisher = {{Wiley-Blackwell}}, series = {{Acta Obstetricia et Gynecologica Scandinavica}}, title = {{Mode of delivery in breech presentation at term: increased neonatal morbidity with vaginal delivery}}, url = {{http://dx.doi.org/10.1034/j.1600-0412.2001.080008731.x}}, doi = {{10.1034/j.1600-0412.2001.080008731.x}}, volume = {{80}}, year = {{2001}}, }