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Mode of delivery in breech presentation at term: increased neonatal morbidity with vaginal delivery

Herbst, Andreas LU and Thorngren-Jerneck, Kristina LU (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)
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author
and
organization
publishing date
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
2020-07-15 03:10:10
@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 &lt;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&lt; 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},
  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},
}