Comparative Study on Breech Deliveries among the Primiparous and Multiparous Women in a Tertiary Care Hospital

Abstract

Introduction: Breech is the commonest mal-presentation where increased perinatal and maternal mortality and morbidity are reported compared to cephalic presentation. This unwanted outcome can only be prevented by planned delivery methods. The aim of the study was to compare fetal outcomes in all delivery methods among the primiparous and multiparous women and thereby helping in preparing appropriate delivery protocol in breech presentation. Methods: This prospective study was done at the Department of Obstetrics & Gynecology of Rangpur Medical College with a total of 104 pregnancies. Appropriate cases of breech presentation were included and all necessary information was noted including predictive factors, management details, and outcome of the delivery. Result: Among the 104 participants of the study, 53 were primiparous pregnancy, and 51 were multiparous pregnancy cases. In total, 28 out of 104 had vaginal deliveries, and 76 had a delivery through cesarean section. The cesarean section had a much higher prevalence (81.13%) among primipara cases. 22 of the primipara and 20 of the multipara cases had planned for vaginal delivery, but successful vaginal delivery was observed to be 22.7% in primiparous women and 45% among multiparous women. The mean age was 24.58 years among the primiparous women and 28.9 years among the multiparous. A higher percentage of multiparous cases (80.4%) had no fetal complications compared to primiparous cases (71.7%). Among neonatal complications, birth traumas were significantly more frequent in the primiparous compared with multiparous. 43.4% of neonates needed admission from the primipara group compared with 33.3% in multipara. Among maternal complications, a higher percentage of multipara women suffered from different morbidities compared to primiparous, which was statistically significant as a whole. Conclusion: Proper planning of delivery methods is important to decrease both maternal and fetal morbidities and mortality irrespective of parity. Primiparous mothers with breech presentation are more prone to undergo cesarean deliveries and thereby develop postoperative complications. But multiparous mothers have more complications during the delivery process. Overall neonatal complications especially birth traumas are more common among the babies of primiparous mothers.