Fetal outcome for infants in breech by method of delivery: experiences with a stand-by service system of senior obstetricians and women's choices of mode of delivery

Abstract

Objective: To show that the fetal outcome in vaginal deliveries (VD) of breech presentation in a setting of a senior obstetrician stand-by system is as good as in planned cesar- ean sections.

Patients and methods: This observational prospective intent-to-treat study (n=211 singleton breech presentation pregnancies of ≥35 weeks of gestation) compared two groups of breech deliveries: planned cesarean sections (PCS, n=126) and intended VD (IVD, n=85) resulting in vaginal deliveries (VD, n=46) as well as secondary cesarean sections (SCS, n=39). Women's informed choice as well as strict pre-selection criteria for vaginally intended breech presentation deliveries was followed.

Results: Fetal outcome of vaginal breech deliveries and of primary as well as SCS (45.9% of IVD) was comparable in terms of cord blood pH, base excess, Apgar score, fetal trauma, and transfer to neonatal intensive care unit.

Conclusions: Vaginal breech delivery is a safe option in a stand-by system of senior obstetricians with controlled decision-making before labor.