Confronting the Fear: Our Experience with Breech Vaginal Delivery-A Retrospective Analysis

Abstract

Introduction: Mode of delivery for term singleton breech presentation has been a raging topic of discussion for decades and continues to be so. The ‘Term Breech Trial’ was a big blow to vaginal breech delivery leading to a torrential increase in the rate of caesarean sections the world over. We intend to compare and evaluate the maternal and perinatal outcomes of vaginal versus caesarean section breech delivery so as to analyse the safety of vaginal delivery for breech presentation. Objectives: Analyse and compare perinatal and maternal outcomes between vaginal versus caesarean deliveries of term or near-term singleton breech presentation. Materials and Methods: Retrospective comparison between 30 vaginal breech deliveries (Group 1) and 252 caesarean deliveries (Group 2) done for singleton breech presentation between 36 weeks to 42 weeks, either in early or advanced labour conducted between January 2015-January 2022 at various Military Hospitals. Statistical Analysis: The association between maternal and perinatal outcomes was estimated using the Chi-square test and Fisher exact test with P < 0.05 considered statistically significant. Results: No maternal complications were noted in Group 1 while in Group 2 surgical site infection and post-partum haemorrhage of varying degree, was noted in 14% cases and 7% cases respectively which was statistically significant. There was no significant difference noted between the groups with regard to neonatal outcomes or NICU admission. Conclusion: Vaginal delivery for termsingleton breech is a reasonable option in well-selected patients at optimally equipped centres, in the hands of an experienced Obstetrician.