Nuruddin Badruddin Mohammed, Rozina Noor Ali, Chinnaiya Anandakumar, Rahat Najam Qureshi, Stephen Luby
Management trend and safety of vaginal delivery for term breech fetuses in a tertiary care hospital of Karachi, Pakistan
Aim: To investigate the safety of vaginal delivery for
term breech fetuses in a tertiary-care hospital of Pakistan.
Methods: We reviewed the medical records of all live
singleton breech deliveries at or beyond 37 weeks of
gestation, at the Aga Khan University Hospital, Karachi,
from January 1988 to December 1995.
Results: Rate of cesarean section increased from 48%
(1988) to 74% (1995). Out of 287 subjects, 158 underwent
elective cesarean section while 129 received a
trial of labor, 77% of which delivered vaginally. There
was no neonatal or maternal death. Compared to babies
delivered by emergency or elective cesarean section,
those delivered vaginally had significantly more neonatal
intensive-care unit admissions (none and 5% versus
13 %) and higher rates of birth trauma (none and 0.6%
versus 7%). However, there was no significant difference
in the Apgar score at 5 minutes and the risk of
maternal complications by delivery mode.
Conclusion: Allowing trial of labor to carefully selected
mothers can result in vaginal delivery in 77%
of the cases. However, the risk of trauma and neonatal
intensive-care unit admissions, among vaginal births
may favor the decision of elective cesarean section, unless
rigorous pre-delivery assessment and conduct of
delivery by adequately trained obstetricians is performed.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 29, 05/2001
Pages: 250 - 259
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