Background: Management of the Breech presentation has been topic of debate since long. Irrespective the route of delivery, breech presentation has been linked with adverse neonatal outcome. Most of the fetuses with breech presentation are delivered by cesarean section in current obstetric practice. External cephalic version is a procedure by which some of the breech presenting fetuses can be converted into cephalic and deliver normally.
Objective: To study the management of breech presentation at term at a tertiary care center in terms of route of delivery, success rates of external cephalic version, neonatal and maternal outcome
Materials and methods: An prospective observational study on 226 patients with breech presentation at term over a period of three years was carried out at a tertiary care center. Selected patients with singleton uncomplicated breech presentation were given a trial of external cephalic version and followed by vaginal delivery if version was successful.
Results: 80% of breech presenting fetuses were single. External cephalic version was attempted in 50% patients with singleton breech presentation. The success rate of external cephalic version was 61%, with 77% of them had normal delivery, 15 % had emergency cesarean section for various obstetrical indications and 7% had vacuum delivery. 92% patients with failed external cephalic version and majority of twin pregnancy with first breech, underwent planned cesarean section. 10 patients presented in advanced labour and had vaginal breech delivery. There was no neonatal or maternal mortality.
Conclusion: Planned cesarean section at term in case of breech presentation is associated with reduction in perinatal mortality and morbidity and also safer than emergency cesarean section in terms of perinatal and maternal morbidity. External cephalic version at term is a safe procedure with success rate near 60% and reduction in cesarean section rate by 25%.
Impact Factor
2022: 6.012
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