Study on feto-maternal outcome in term singleton pregnancies with breech presentation at tertiary care centre, Jodhpur

Abstract

Background: Breech presentation is a longitudinal lie of the foetus with the caudal pole occupying the lower part of the uterus and cephalic pole in the uterine fundus. The prevalence of term breech presentation varies globally. Breech presentation and delivery have been classified as high risk because of the increased incidence of perinatal and maternal complications. Comprehensive obstetric care and intensive neonatal care play a crucial role to decrease complications related to breech delivery. Objective: To evaluate feto-maternal outcome including mode of delivery in term singleton pregnancies with breech presentation. Material and Methods: An observational study was conducted on all pregnant women with term singleton breech presentation. A rapid assessment was made to establish the stage of labor, status of membrane and condition of the foetus. Close surveillance of foetal heart rate and uterine contraction was monitored. Vaginal examination was done to know the state and dilation of cervix, type of breech and its status. Status of membranes and the pelvis with assessment of fetopelvic disproportion. Results: The incidence of term breech delivery was 3.63%. The most common complication in term breech presentation was contracted pelvis (6%). The incidence of perinatal morbidity was 9% with maximum case of birth asphyxia (5%). The incidence of perinatal mortality was 8.48% among that in multigravidia parity it was 7.4% and in primigravidia it was 1.08%. Conclusion: It is concluded that the balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation.