A Retrospective Review of Breech Deliveries with Maternal & Fetal Outcomes at a Tertiary Care Hospital Peshawar, Pakistan

Abstract

The objective of this research is to determine the maternofetal issues of breech presentation at a Tertiary Care Hospital in Pakistan along with maternal and fetal outcomes in respective to modes of delivery.  A retrospective review of 200 breech deliveries between January, 2010 and December, 2011 were performed. All breech presentations included both booked and non-booked patients, and breech pregnancies with incomplete data and successful ECV were not the part of the study. APGAR score, birth injuries and neonatal deaths were evaluated as variables of interest. Duration of hospital stay, perineal injuries, post-operative complications like ileus, infections of chest, wound, endometritis, urinary tract and genital were the prominent variables to be evaluated in relation to maternal morbidity. The incidence of breech pregnancy over 2 years in this study was 3.6% (Total deliveries 5489, breech 200). Breech presentation was significantly associated with multi-parity. Mothers younger than 29 years were significantly related with cesarean section of the lower segment 87% [82 out of 94 deliveries] Moreover 77% [ 54 out of 70] of the babies delivered as breech vaginal delivery, weighed between 2.5- 3.5 kg. The maternal complications included were, short term, like chest, wound infections and endo-metritis and prolonged hospital stay in LSCS. Most of the females with breech presentation were in advanced labor and un-booked. Maternal morbidity was high in operative abdominal delivery. Early booking and regular follow up after the diagnosis at 36weeks at Tertiary Centers may help in reducing risks and improve outcomes. Trainings in External Cephalic Version is mandatory for the trainees to combat with such situations and to improve the outcomes.