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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)
Please use this url to cite or link to this publication:
author
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
2008-06-30 13:56:32
date last changed
2018-05-29 11:05:59
@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},
  keyword      = {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},
  volume       = {80},
  year         = {2001},
}