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Vaginal versus cesarean breech delivery: maternal and neonatal outcomes at Bulacan Medical Center – a two-year retrospective study

Jerica Miah Delos Santos-Borgonia, MD; Angelita R. Teotico, MD, FPOGS, FPSUOG, FPSMFM; Rodante P. Galiza, FPOGS Alejandro R. San Pedro, MD, FPOGS
Department of Obstetrics and Gynecology, Bulacan Medical Center

Objective: To compare the maternal and neonatal outcome of vaginal and cesarean breech deliveries at Bulacan Medical Center

Materials and Methods: A two-year retrospective descriptive study on all patients who delivered breech by vaginal or cesarean section from January 1, 2012 to December 31, 2013. The maternal and neonatal outcomes were compared and analyzed.

Results: There were 165 deliveries included during the study period. There were 83 cases of vaginal breech delivery and 82 cases of cesarean breech delivery. The incidence and risk of postpartum hemorrhage is higher among cesarean breech delivery (7%). Febrile morbidity(p=0.0223) is significantly lower for vaginal breech births. Cesarean breech delivery is correlated with longer hospital stay (p=<0.0001). There were no significant differences on the incidence of asphyxia (5% vs 2%, RR=0.51, RD=-2%, p=0.4141), birth trauma (2% vs 1%, RR=0.51, RD=-1%, p=0.5673) and sepsis (12% vs 9%, RR=0.71, RD=-4%, p=0.4582) for vaginal or cesarean breech delivery. Prolonged hospital stay is 2.10 times more likely to occur for csarean breech deliveries compared with vaginal breech deliveries. Thus, shorter hospital stay means lesser hospital costs fo both mother and babies.

Conclusion: There is no significant difference in maternal and perinatal morbidity and mortality between vaginal and cesarean breech delivery except for longer hospital stay and increased febrile morbidity for cesarean births. It is therefore safe to recommend vaginal breech delivery under hospital-specific guidelines for labor management such as strict selection of patients, high quality fetal monitoring and high level of competence among obstetricians to deliver breech.