TY - JOUR

T1 - Breech at term--mode of delivery?

T2 - A register-based study

AU - Krebs, L

AU - Langhoff-Roos, J

AU - Weber, T

PY - 1995/10

Y1 - 1995/10

N2 - BACKGROUND: The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other.METHODS: Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death.RESULTS: A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores.CONCLUSIONS: Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by cesarean section.

AB - BACKGROUND: The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other.METHODS: Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death.RESULTS: A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores.CONCLUSIONS: Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by cesarean section.

KW - Apgar Score

KW - Birth Weight

KW - Breech Presentation

KW - Cesarean Section

KW - Decision Making

KW - Delivery, Obstetric

KW - Denmark

KW - Female

KW - Humans

KW - Infant Mortality

KW - Infant, Newborn

KW - Male

KW - Parity

KW - Pregnancy

KW - Pregnancy Outcome

KW - Registries

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

M3 - Journal article

C2 - 7572104

VL - 74

SP - 702

EP - 706

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - 9

ER -