Background Following the term breech trial, elective caesarean section has been the preferred mode of delivery for term breech presentations.1 The practice has recently changed and with proper selection, more breech babies are being delivered vaginally.
Aim To evaluate the practice and outcomes of term breech deliveries in a busy tertiary trust.
Methods Retrospective case-note analysis of term singleton breech deliveries over 2008-2010 at St James University Hospital and Leeds General Infirmary.
Results Out of 71 case-notes audited, 35 (49.3%); 28 (39.4%) and 8 (11.3%) patients were delivered by planned caesarean (EL.LSCS); emergency caesarean (Em.LSCS) and vaginal breech (VBD) respectively. For the El.LSCS group 20 (57.1%) were primigravida and 15 (42.9%) were para-1 or more of which 6 were previous caesarean section. External cephalic version (ECV) was attempted antenatally in 6 patients (17.1%). Average birth weight was 3.03kg with 3 admissions to the neo-natal unit (NNU). In the Em.LSCS group 18 (64.3%) were primigravida. ECV was attempted antenatally in 4 (14.3%). No ECV's were attempted in labour. Average birth weight was 3.42kg. Reasons for Em.LSCS was mostly just for breech presentation (82.1%) and the rest were for failure to progress and foetal distress. There were no admissions to the NNU. In the vaginal breech delivery group 3 (37.5%) were primigravida. Average birth weight was 3.13kg and there were no admissions to the NNU.
Conclusions The babies admitted to NNU were exclusively from the EL. LSCS group and the rates of ECV and vaginal breech delivery remain low.
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