Route of breech delivery and maternal and neonatal outcomes

L. Sanchez-Ramos, T. L. Wells, Charles Adair, G. Arcelin, A. M. Kaunitz, D. S. Wells

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective: To compare maternal and neonatal outcomes in elective cesarean vs. attempted vaginal delivery for breech presentation at or near term. Methods: We reviewed the maternal and neonatal charts of all singleton breech deliveries of at least 35 weeks' gestation or 2000 g delivered between 1986 and 1997 at our institution. Patients delivered by elective cesarean were compared to those attempting a vaginal delivery. The neonatal outcomes analyzed were: corrected mortality; Apgar scores less than 7 at 5 min; abnormal umbilical cord blood gases; birth trauma; and admissions to the intensive care nursery. Maternal morbidity was also assessed and compared. Results: Of 848 women meeting criteria for evaluation, 576 were delivered by elective cesarean while 272 attempted a vaginal delivery. Of 272 women undergoing a trial of labor, 203 (74.6%) were delivered vaginally, while 69 (25.4%) failed an attempt at vaginal delivery and underwent a cesarean. When comparing patients delivered by elective cesarean with those attempting a vaginal delivery, no significant differences were noted in neonatal outcomes. However, maternal morbidity was higher among women delivered by cesarean, regardless of the indications for the procedure. Similar neonatal and maternal results were noted when nulliparous patients were analyzed separately. Conclusions: Cesarean delivery of selected near-term infants presenting as breech is associated with increased maternal morbidity without corresponding improvement in neonatal outcomes.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalInternational Journal of Gynecology and Obstetrics
Volume73
Issue number1
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

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Mothers
Morbidity
Trial of Labor
Breech Presentation
Apgar Score
Nurseries
Critical Care
Fetal Blood
Gases
Parturition
Pregnancy
Mortality
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Route of breech delivery and maternal and neonatal outcomes. / Sanchez-Ramos, L.; Wells, T. L.; Adair, Charles; Arcelin, G.; Kaunitz, A. M.; Wells, D. S.

In: International Journal of Gynecology and Obstetrics, Vol. 73, No. 1, 01.01.2001, p. 7-14.

Research output: Contribution to journalArticle

Sanchez-Ramos, L. ; Wells, T. L. ; Adair, Charles ; Arcelin, G. ; Kaunitz, A. M. ; Wells, D. S. / Route of breech delivery and maternal and neonatal outcomes. In: International Journal of Gynecology and Obstetrics. 2001 ; Vol. 73, No. 1. pp. 7-14.
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