DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20204808

Retrospective analysis of breech deliveries in tertiary care center

Suneela Mullakkal Sankaran, Jayasree Sukumara Sukumara Pillai

Abstract


Background: Breech presentation is the commonest malpresentation accounting for 3-4% of all deliveries at term. The most common cause for breech presentation is preterm delivery. The safest route of delivery for breech had long been a topic of debate and after the results of term breech trial mode of delivery has become abdominal route even in teaching institutions.

Methods: This is a retrospective cross sectional study conducted at department of obstetrics and gynaecology, Government medical college, Kozhikode, for a period of 2 years from 01 January 2016 to 31 December 2017. Mothers with gestational age between 28 weeks to 41 weeks with singleton live fetus with breech presentation who had either vaginal or caesarean delivery were included. The case notes were retrieved from the medical records department.

Results: A total of 823 breech deliveries occurred during the study period. Of the total mothers 429 were primies and 394 were multies. Common causes identified were prematurity, intrauterine growth restriction, uterine and fetal anomalies. Mode of delivery was caesarean in more than 80% of cases.

Conclusions: Incidence of breech presentation was 3.2% during the study period. Increasing incidence of caesarean delivery is seen in breech presentation. Persistent breech presentation at term is most commonly seen in patients with associated oligamnios, intrauterine growth restriction, and uterine anomalies.


Keywords


Breech, Oligamnios, Intrauterine growth restriction

Full Text:

PDF

References


Gunay T, Turgut A, DemirciviBor E, Hocaoglu M. Comparison of maternal and fetal complications in pregnant women with breech presentation undergoing spontaneous or induced vaginal delivery, or cesarean delivery. Taiwanese J Obstet Gynecol. 2020;59(3):392-7.

Filipov E, Borisov I, Kolarov G. Placental location and its influence on the position of the fetus in the uterus. Akush Ginekol (Sofiia). 2000;40:11-2.

Sekulic S, Ilincic M, Radeka G, Novakov-Mikic A, Simic S, Podogorac J. Breech presentation and the cornual-fundal location of the placenta. Croatian Med J. 2013;54(2):198-202.

Luterkort M, Persson PH, Weldner BM. Maternal and fetal factors in breech presentation. Obstet Gynecol. 1984;64(1):55-9.

Toijonen A, Heinonen S, Gissler M. Macharey G. Risk factors for adverse outcomes in vaginal preterm breech labour. Arch Gynecol Obstet. 2020.

Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaaginal birth for breech presentation at term; a randomized multicenter trial. Term Breech Trial Collaborative Group. Lancet. 2000;356:1375-83.

Goffinet F, Carayol M, Foidart JM, Alexander S, Uzan S, Subtil D, et al. Is planned delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Obstet Gynecol. 2006;194(4):1002-11.

Hickok DE, Gordon DC, Milberg JA, Williams MA, Dailing JR. The frequency of breech presentation by gestational age at birth: a large population-based study. Am J Obstet Gynecol. 1992;166(3):851-2.

Rauf B, Ayub T. Maternal and perinatal outcome in term singleton breech presentation. J Postgrad Med Inst. 2004;18:373-9.

Sherer DM, Spong CY, Minior VK, Salafia CM. Increased incidence of fetal growth restriction in association with breech presentation in preterm deliveries <32 weeks. Am J Perinatol. 1997;14(1):35-7.

Fruscalzo A, Londero AP, Salvador S, Bertozzi S, Biasioli A, Della Martina M, et al. New and old predictive factors for breech presentation: our experience in 14433 single ton pregnancies and a literature review. J MaternaL Fetal Neonatal Med. 2014;27(2):167-72.

Zeitlin J, EI Ayoubi M, Jarreau PH, Draper ES, Blondel B, Kunzel W, et al. Impact of fetal growth restriction on mortality and morbidity in very preterm birth cohort. J Pediatr. 2010;157(5):733-79.

Cammu H, Dony N, Martens G, Colman R. Common determinants of breech presentation at birth in singletons; a population based study. Eur J Obstet Gynecol Reprod Biol. 2014;177:106-9.

Kalogiannidis I, Masouridou N, Dagklis T, Masoura S, Goutzioulis M, Prapas Y, Prapas N. Previous caesarean section increases the risk of breech presentation at term pregnancy. Clin Exp Obstet Gynecol. 2010;37(1):29.

Vendittelli F, Riviere O, Creen-Herbert C, Rozan MA, Maria B, Jacquetin B, etal. Is a breech presentation at term more frequent in women with a history of caesarean delivery? Am J Obstet Gynecol. 2008;198(5):521.

Harrington K, Thompson O, Jordan L, Page J, Carpentor RG, Campbell S. Obsteric outcome in women who present with a reduction in fetal movements in the third trimester of pregnancy. J Perinatol Med. 1998;26(20):77-82.

Hehir MP, O’Connor HD, Kent EM, Fitzpatrick C, Boylan PC, Coulter-Smith S, et al. Changes in vaginal breech delivery in a single large metropolitanarea. Am J Obstet Gynecol. 2012;206(6):498.

Zsirai L, Csakany GM, Vargha P, Fulop V, Tabak AG. Breech presentation: its predictors and consequences.An analysis of the Hungarian Tauffer Obstetric Database (1996-2011). Acta Obstet Gynecol Scand. 2006;95(3):347-54.

Giri A, Srivastav VR, Suwal A, Tuladhar AS. Advanced maternal age and obstetric outcome. Nepal Med Coll J. 2013;15:87-90.

Rayl J, Gibson PJ, Hickok DE. A population –based case-control study of risk factors for breech presentation. Am J Obstet Gunecol. 1996;174:28-32.

Olatunji AO, Sule AO. Term breech delivery at a University hospital in Nigeria. Niger Postgrad Med J. 1999;6:171-4.

Talas BB, Altinkaya SO, Talas H, Danisman N, Gungor T. Predictive Factors and short –term fetal outcomes of breech presentation: A Case – Control study. Taiwan J Obstet Gynecol. 2008;4(4):402-7.

Luterkort M, Persson PH, Weldner BM. Maternal and fetal factors in breech presentation. Obstet Gynecol Res. 2005;31:409-13.

Saastad E, Vangen S, Froen JF. Suboptimal care in stillbirths-a retrospective audit study. Acta Obstet Gynecol Scand. 2007;86(4):444-50.

Demol S, Bashiri A, Furman B, Maymon E, Shoham-Vaedi I, Mayzor M. Breech presentation is a risk factor for intrapartum and neonatal death in preterm delivery. Eur J Obstet Gynecol Reprod Biol. 2000;93:47-51.

Lee HC, El-Sayed YY, Gould JB. Population trends in cesarean delivery for breech presentation in the United States, 1997-2003. Am J Obstet Gynecol. 2008;199(1):1-59.

Toijonen AE, Heinonen ST, Gissler MVM, Macharey G. A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case-control study. Arch Gynecol Obstet. 2020;301(2):393-403.

Newtonraj A, Kaur M, Gupta M, Kumar R. Level, causes, and risk factors of stillbirth: a population based case control study from Chandigarh. India. BMC Pregnancy Childbirth. 2017;17:371.

Figueras F, Caradeux J, Crispi F,Eixarch E, Peguero A, Gratacos E. Diagnosis and surveillance of late-onset fetal growth restriction. Am J Obst Gynecol. 2018;218(2):790-802.

Mostello D, Chang JJ, Bai F, Wang J, Guild C, Stamps K, Leet TL. Breech presentation at delivery: a marker for congenital anomaly? J Perinatol. 2014;34(1):11-5.