MATERNAL AND FETAL RISKS OF PLANNED VAGINAL BREECH DELIVERY VS PLANNED CAESAREAN SECTION FOR TERM BREECH BIRTH
DOI:
https://doi.org/10.59743/Keywords:
Breech presentation, Cesarean delivery, Breech complications, Induced vaginal delivery, Spontaneous delivery, LibyaAbstract
The management of breech presentations, irrespective of the delivery method-vaginal or cesarean-continues to be a topic of considerable debate within the field of obstetrics. This investigation sought to assess the relative risks of maternal and fetal mortality, along with perinatal morbidity, linked to vaginal delivery in comparison to elective cesarean section in instances of breech presentation. The study was conducted on 830 patients at Zliten Medical Center, Libya, from January 2022 to April 2024. The age distribution of participants was as follows: 18-24 years (29.87%), 25-30 years (36.50%), 31-35 years (23.25%), and 36-40 years (10.36%). In agreement with previous research, the predominant proportion of expectant mothers exhibiting a breech presentation fell within the age range of 18 to 30 years. The findings revealed that 42.65% of breech deliveries were vaginal, while 57.34% were performed via cesarean section. Neonatal complications associated with both vaginal and cesarean breech deliveries included clavicle fractures (6.50%), femur fractures (3.49%), brachial plexus injuries (5.06%), cephalhematoma (3.97%), intracranial bleeding (5.78%), and pneumothorax. Maternal complications during labor in breech presentation cases included vaginal hematoma (9.87%), vaginal lacerations (9.03%), perineal injuries (7.83%), decline in hemoglobin levels (9.39%), and postpartum endometritis (9.75%), while 54.09% of cases had no complications. These findings highlight the importance of selecting vaginal delivery in carefully evaluated breech cases, alongside ensuring proper training for obstetricians in vaginal breech delivery techniques, addressing medicolegal concerns, and encouraging physicians to perform more vaginal breech deliveries to reduce the high rate of cesarean sections in such cases.
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Niles KM, Barrett JFR, and Ladhani NNN (2019) compared outcomes of cesarean versus vaginal delivery for extremely preterm breech presentations in a retrospective cohort study. Journal of Maternal-Fetal & Neonatal Medicine, 32(7):1142-1147.
Assefa F, Girma W, Woldie M, and Getachew B (2019) analyzed birth outcomes of singleton term breech deliveries at Jimma University Medical Center, Ethiopia. BMC Research Notes, 12(1):428.
Berhan Y and Haileamlak A (2016) conducted a meta-analysis comparing risks of planned vaginal breech delivery versus planned cesarean section for term breech births, including observational studies. BJOG: An International Journal of Obstetrics & Gynaecology, 123(1):49-57.
Burgos J, Rodríguez L, Cobos P, Osuna C, Del Mar Centeno M, and Larrieta R (2015) reviewed a decade of experience in managing breech presentations at term. Journal of Perinatology, 35(10):803-808.
Macharey G, Gissler M, Rahkonen L, Ulander VM, Vaisanen-Tommiska M, Nuutila M, and Heinonen S (2017) investigated obstetric risk factors associated with breech presentation at term in a nationwide cohort study. Archives of Gynecology and Obstetrics, 295(4):833–838.
Hogberg U, Claeson C, Krebs L, Svanberg AS, and Kidanto H (2016) examined breech deliveries at a Tanzanian university hospital. BMC Pregnancy and Childbirth, 16(1):342.
Wängberg Nordborg J, Svanberg T, Strandell A, and Carlsson Y (2022) performed a systematic review and meta-analysis comparing intended cesarean section versus intended vaginal delivery for term breech presentations. Acta Obstetricia et Gynecologica Scandinavica, 101(6):564-576.
Sananès N (2020) outlined CNGOF guidelines for breech presentation, focusing on neonatal and child outcomes of planned vaginal delivery versus elective cesarean section. Gynecologie, Obstetrique, Fertilite & Senologie, 48(1):95-108.
Anuwutnavin S, Kitnithee B, Chanprapaph P, Heamar S, and Rongdech P (2020) compared maternal and perinatal morbidity between elective and emergency cesarean sections for singleton-term breech presentations. Journal of Obstetrics and Gynaecology, 40(4):500-506.
Sentilhes L, Schmitz T, Azria E, Gallot D, Ducarme G, Korb D, Mattuizzi A, Parant O, Sananès N, Baumann S, Rozenberg P, Senat MV, and Verspyck É (2020) summarized CNGOF guidelines for breech presentation. Gynecologie, Obstetrique, Fertilite & Senologie, 48(1):63-69.
Kotaska A and Menticoglou S (2019) provided guidelines for managing breech presentation at term. Journal of Obstetrics and Gynaecology Canada, 41(8):1193-1205.
Jennewein L, Kielland-Kaisen U, Paul B, Möllmann CJ, Klemt AS, Schulze S, Bock N, Schaarschmidt W, Brüggmann D, and Louwen F (2018) studied maternal and neonatal outcomes after vaginal breech delivery at term, stratified by fetal weight. PLoS One, 13(8):e0202760.
Högberg U, Claeson C, Krebs L, Svanberg AS, and Kidanto H (2016) analyzed breech deliveries at a Tanzanian university hospital. BMC Pregnancy and Childbirth, 16(1):342.
Bergenhenegouwen L, Ensing S, Ravelli AC, Schaaf J, Kok M, and Mol BW (2016) investigated subsequent pregnancy outcomes after preterm breech delivery in a population-based cohort study. Journal of Maternal-Fetal & Neonatal Medicine, 29(15):2540-2544.
Ekéus C, Norman M, Åberg K, Winberg S, Stolt K, and Aronsson A (2019) evaluated neonatal morbidity and mortality after vaginal breech delivery at term in a Swedish population-based cohort study. Journal of Maternal-Fetal & Neonatal Medicine, 32(2):265-270.
Gunay T, Turgut A, Demircivi Bor E, and Hocaoglu M (2020) compared maternal and fetal complications in breech presentations undergoing spontaneous or induced vaginal delivery versus cesarean delivery. Taiwan Journal of Obstetrics and Gynecology, 59(3):392-397.
Sorensen HA, Obel J, Schroll JB, and Krebs L (2023) conducted a systematic review of perinatal and maternal outcomes in vaginal versus cesarean breech deliveries in low-income settings. International Journal of Gynecology & Obstetrics, 161(1):17-25.
Bjellmo S, Andersen GL, and Martinuseen MP (2017) assessed whether vaginal breech delivery is associated with higher risks of perinatal death and cerebral palsy compared to vaginal cephalic birth in a Norwegian registry-based cohort study. BMJ Open, 7(4):e014979.
Fuxe V, Brismar Wendel S, Bohm-Starke N, and Mühlrad H (2022) explored delivery mode and severe maternal and neonatal morbidity among singleton term breech births in a population-based cohort study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 272(1):166-172.
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