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Mode of delivery in...
Mode of delivery in breech presentation at term: increased neonatal morbidity with vaginal delivery
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- Herbst, Andreas (author)
- Lund University,Lunds universitet,Obstetrik och gynekologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Obstetrics and Gynaecology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Thorngren-Jerneck, Kristina (author)
- Lund University,Lunds universitet,Pediatrik, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Paediatrics (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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(creator_code:org_t)
- 2001-12-20
- 2001
- English.
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 80:8, s. 731-737
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Abstract
Subject headings
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- 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- breech presentation
- cesarean section
- neonatal morbidity
- vaginal delivery
Publication and Content Type
- art (subject category)
- ref (subject category)
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