Birth outcomes of singleton term breech deliveries in Jimma University Medical Center, Southwest Ethiopia

Fanta Assefa,Mirkuzie Woldie,Woubishet Girma,Biniam Getachew

doi:10.1186/s13104-019-4442-6

Fanta Assefa, Mirkuzie Woldie + Show 2 more

Open Access

https://doi.org/10.1186/s13104-019-4442-6

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Abstract

ObjectiveBreech delivery is generally associated with higher perinatal morbidity and mortality than cephalic presentation. Hence describing the outcomes of singleton term breech deliveries in Jimma University Medical Center (JUMC), Southwest Ethiopia addresses in recommendation of improving perinatal outcomes and developing protocols in selecting eligible women.ResultsThe incidence of singleton term breech delivery was 5.3%. Majority, (52.8%) of them had undergone emergency cesarean delivery (C/D), and 38.9% had vaginal breech delivery. There were 14 (13.9%) intrapartum fetal deaths of whom 5.6% were recorded at JUMC. A quarter (25%) of the neonates required admission to the neonatal intensive care unit; 40.7% had perinatal asphyxia, and there were 3 early onset neonatal deaths making up a perinatal mortality rate of 157.4 per 1000 breech births. The incidence of breech delivery was relatively high. Vaginal breech delivery was lower. Significant proportions of adverse perinatal outcomes were recorded. Introduction of a protocol for managing breech deliveries to select eligible women for trial of breech delivery and strengthen training of junior health professionals regularly on how to conduct assisted vaginal breech delivery to improve perinatal outcome is recommended. Further studies to identify determinants of perinatal outcomes is recommended.

Highlights

Other studies from Nigeria and Ethiopia revealed the incidence of singleton term breech deliveries to be 2.6% and 4% respectively [6, 7]
The debate surrounding the best mode of delivery is twofold; what are the best clinical practice guidelines in terms of risk management and what are the risks versus benefits of cesarean delivery (C/D) between the fetus and the mother [8]
This change in clinical practice was largely due to evidence from randomized trials, the Term Breech Trial, that revealed a policy of planned C/D for term breech presentation was associated with a significantly large decrease in perinatal/neonatal mortality and neonatal morbidity with only a modest increase in short-term maternal morbidity, compared with that of a policy of planned vaginal delivery [9–11]

Summary

Introduction

Breech presentation is defined as a fetus in a longitudinal lie with the buttocks or feet closest to the cervix. Studies have shown that the prevalence of term breech presentation varies globally. Other studies from Nigeria and Ethiopia revealed the incidence of singleton term breech deliveries to be 2.6% and 4% respectively [6, 7]. In the United States, C/D for breech presentation rose from 12% in 1970 to 87% in 2001. This change in clinical practice was largely due to evidence from randomized trials, the Term Breech Trial, that revealed a policy of planned C/D for term breech presentation was associated with a significantly large decrease in perinatal/neonatal mortality and neonatal morbidity with only a modest increase in short-term maternal morbidity, compared with that of a policy of planned vaginal delivery [9–11]

Results

Discussion

Conclusion