To Study Maternal and Neonatal Outcomes in Breech Delivery

Breech is the malpresentation in which podalic pole presents at pelvic inlet and its incidence is 3-4%. Frank breech, complete breech and footling or incomplete breech are the types of breech presentation. Factors responsible for breech presentation include prematurity, uterine abnormalities, foetal abnormalities and multiple gestations. Specifically, following one breech delivery, the recurrence rate for a second pregnancy with breech presentation was nearly 10 percent, and that for a subsequent third pregnancy was 27 percent. Perinatal mortality is increased 2-4 fold with breech presentation irrespective of the mode of delivery. Perinatal mortality for breech presentation at term is about 4-5% for vaginal delivery and 2-4% for caesarean section. The higher perinatal mortality and morbidity associated with breech presentation is mainly due to prematurity, congenital malformation, birth asphyxia and trauma. The management of breech presentation is External Cephalic Version (ECV), planned caesarean section and vaginal breech delivery. ECV may reduce the number of breech presentations and caesarean section, while caesarean section has a higher maternal morbidity in terms of febrile illness and increased duration of hospital stay with small risk of perinatal mortality. Three types of breech deliveries are- spontaneous breech delivery, assisted breech delivery and breech extraction.