Abstract
Breech presentation persists in 3-4% of all term deliveries. There is a threefold increase in perinatal mortality for breech infant delivered vaginally which is related to birth asphyxia and birth trauma. The most frequent cause of death in neonates delivered through breech is intracranial hemorrhage; so many obstetricians recommend caesarean section for breech presentation. It is a retrospective study regarding management of term breech presentation conducted in King George Hospital, Vishakhapatnam from 2012 to 2015 and the results are compared with a similar study conducted in 1981-1984.There is an increase in incidence of caesarean section and decrease in perinatal mortality in our present study when compared to previous study. Increase in caesarean section for breech delivery has decreased the overall incidence of perinatal mortality.
Highlights
Breech presentation persists in 3-4% of all term deliveries
Breech presentation is associated with an increased risk of preterm birth, low birth weight[2, 3] and perinatal morbidity and mortality[4, 5]
The most frequent cause of death in breech delivered through vagina is intracranial hemorrhage due to tentorial tears as a result of excessive pressure on after coming head of breech .Current obstetric thinking regarding vaginal delivery of term breech fetus has been tremendously influenced by the results reported from the “TERM BREECH TRIAL COLLOBORATIVE GROUP” [Hannah 2000]1 .So many of the obstetricians recommend caesarean section for breech presentation in view of all above mentioned risks
Summary
There is a threefold increase in perinatal mortality for breech infant delivered vaginally which is attributed to asphyxia and birth trauma. Perinatal mortality is defined as intrapartum death or death within a week following birth. It is a test of obstetrician’s experience, skill and judgment in this context. The most frequent cause of death in breech delivered through vagina is intracranial hemorrhage due to tentorial tears as a result of excessive pressure on after coming head of breech .Current obstetric thinking regarding vaginal delivery of term breech fetus has been tremendously influenced by the results reported from the “TERM BREECH TRIAL COLLOBORATIVE GROUP” [Hannah 2000]1 .So many of the obstetricians recommend caesarean section for breech presentation in view of all above mentioned risks
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