Revisiting the mode of delivery and outcome of singleton breech delivery in a tertiary health facility in Nigeria.
Background: Breech presentation is associated with increased risk of adverse fetal and maternal outcome. The delivery options for breech presentation are still one of the most disputable issues among Obstetricians worldwide.
Objectives: This study is to determine the outcome of term singleton breech deliveries among booked women in University of Port Harcourt Teaching Hospital (UPTH). It is also to evaluate the current practice of elective caesarean section and assisted vaginal breech delivery for all nulliparous and multiparous women respectively.
Materials and Methods: This was a 5-year review of hospital records of singleton breech deliveries among booked patients between 1st of January 2009 - 31st of December 2013.
Results: The incidence of singleton breech delivery at tenn was 2.10%. Nulliparity accounted for 35.5% while grandmultiparily accounted for 4.4%. One hundred and fony one (51.8%) women had emergency caesarean section, 67 (24.6%) had elective caesarean section and 64 (23.5%) had assisted vaginal breech delivery, No external cephalic version was performed. Nullipara with breech presentation was the commonest indication for caesarean section. Assisted vaginal breech delivery was associated wilh high rate of low Apgar score (score <7) at the 5th minute when compared 10 elective caesarean section (p = 0,000088). There was an increased rate of special care baby unit admission in the group that had assisted vaginal breech delivery than in those that had elective caesarean section. There was no difference in terms of birth injury, neonatal death and maternal morbidities between those that had assisted vaginal breech delivery and elective caesarean section.
Conclusion: Assisted vaginal breech delivery was associated with higher incidence of low Apgar score at the fifth minute especially in the nulliparous patient. It is advisable to offer elective caesarean section to nulliparae with breech presentation whereas the mode of delivery in the multipara should be individualized. There is need to introduce the practice of external cephalic version in the study centre.
Key words: Breech deliveries, maternal and fetal outcomes, Port Harcourt.
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