THE MANAGEMENT AND SAFETY OF VAGINAL DELIVERY FOR TERM BREECH FETUSES IN A TERTIARY CARE HOSPITAL

Dr. Sonali Rani Mustofi*, Professor Dr. Ranjit Basak, Professor Dr. Ferdousi Sultana and Dr. Abu Zafar Al Murad

ABSTRACT

Objective: In this study our main goal is to evaluate the management and safety of vaginal delivery for term breech fetuses in a tertiary care hospital. Method: This cross-sectional study was carried out at tertiary medical college and hospital where we studied 120 pregnancies with 37 completed weeks of gestation and with a live singleton baby presenting as breech. Various pre-delivery maternal and neonatal characteristics were compared for three groups of patients: those delivered by planned cesarean section without undergoing a trial of labor (elective cesarean section) n=40, those allowed a trial of labor but were subsequently delivered by cesarean section (emergency cesarean section) n=40, and those given a trial of labor that culminated in a vaginal delivery (vaginal delivery) n=40. Results: During the study, in all group multiparous cases were common (vaginal delivery= 51%, Emergency cesarian delivery= 52% and elective cesarian delivery=56%). In term of breech cases completing cases were common (vaginal delivery=80%, Emergency cesarian delivery= 60% and elective cesarian delivery=90%). In vaginal delivery group 13% neonatal needs intensive care admissions whereas for emergency cesarian delivery there was no neonatal need intensive care and elective cesarean delivery cases 6% neonatal needs intensive care admissions. The cesarean section groups had on an average; a significantly longer hospital stay (7 days) compared to the vaginally delivered group (3days). Conclusion: From our result we can conclude that, women and their obstetricians may consider elective cesarean delivery as a reasonable option for term breech fetuses, which might result in loss of skills of young obstetricians in conducting vaginal breech deliveries and in the antecedent implications of repeat cesarean section.

Keywords: Vaginal delivery, breech fetuses, cesarean section.