The New Indian Journal of OBGYN. 9(2):323-327

Outcome of breech presentation after 34 weeks of period of gestation of pregnancy

Rajesh Kumar Mishra, Shakti Vardhan, Sushil Chawla

ABSTRACT

Background & objective: Management of breech presentation at term remains an area of controversy in modern obstetrics. Most cases are delivered by cesarean delivery in present practice in the absence of concrete evidence in its favour. A study was conducted to evaluate the route of delivery, maternal and perinatal outcome in cases of singleton breech presentation beyond 34 weeks of period of gestation. Method: A prospective observational study was carried out at a tertiary care hospital over a period of one year. This study included a total of 225 cases of breech presentation beyond 34 weeks. External cephalic version was carried out in suitable cases. These patients were followed up till delivery and data was collected and analysed regarding the mode of delivery, maternal and neonatal outcome. Result: The incidence of breech presentation at term was 3.24% (154 cases out of 4745 deliveries); out of which 45.3% were primigravida women and 54.7% multigravida. Spontaneous cephalic version was observed in a significant number of cases i.e.71 out of 225 (31.5%) women. External cephalic version was successful in 17 out of 29 cases with a success rate of 59%. The primary route of delivery for breech presentation was cesarean delivery constituting 147 cases (65%) and remaining 78 cases (35%) had vaginal birth including six cases of assisted breech deliveries. Conclusion: A significant number of cases of breech fetuses undergo spontaneous version even in late third trimester. External cephalic version is an effective procedure to reduce the rate of cesarean delivery in singleton pregnancies with breech presentation.