Abstract

Background: The literature is inconclusive regarding vaginal breech delivery and cesarean breech delivery outcomes for preterm neonates and maternal morbidity and the mortality of these birth modes.

Aim: To investigate the physical and metabolic effects of breech vaginal delivery (VD) and breech cesarean delivery (CD) on preterm infants both more than and less than 1 kg at birth. Methodology: Data was collected from women who had preterm breech delivery between 23 + 0 and 36 + 6 weeks via CS (n = 174) or vaginal route (n = 54) from year 2011 to 2014. The effects of VD or CD deliveries on preterm infants who were less than or more than 1 kg at birth were tested using the chi-square (?2) test. Maternal outcomes were investigated and included high-dependency unit admission, postpartum hemorrhage and red blood cell transfusions.

Results:  Stillbirth and neonatal death rates were higher in the <1 kg VD group (p <0.05).Preterm singleton breech neonates with a birth weight >1 kg have similar outcomes, irrespective of birth mode. There was no significant difference in rates of birth trauma, apnea of prematurity, respiratory distress syndrome and cardiopulmonary resuscitation. Admission rates to special care nursery or neonatal intensive care unit, jaundice and hypoglycemia were unequivocal between groups (p > 0.05). Maternal outcomes revealed no significant difference between VD and CD groups (p > 0.05).

Conclusion: CD carries lower rates of perinatal morbidity and mortality for smaller birth weight (<1 kg) infants. Maternal outcomes between VD and CD revealed no significant difference.