A Study of Breech Presentation and Maternal and Perinatal Outcome in a Tertiary Care Hospital of Western Rajasthan

Abstract

BACKGROUNDBy definition breech presentation means foetal buttocks or the podalic pole of foetus is the presenting part, with sacrum being the denominator. Most newborns are born with cephalic presentation, but at the end of pregnancy around 2.5%-3% are found to be breech Before the end of pregnancy, the breech presentation is much more common about 20% of babies at 28 weeks are breech and 15% at 32 weeks. Caesarean section for breech presentation has been suggested as a way of reducing the associated perinatal problems in many institutions. . Studying breech presentation from the aspect of incidence, aaetiology, type along with maternal & perinatal outcome. RESULTSDuring given period there were 6153 deliveries. The study consisted of 172 cases of breech delivery out of them there were 106 term and preterm constituted 66 cases. Most women belonged to 21-25 years of age group. Prevalence of breech delivery in this study was 2.79% Breech presentation was more common in multipara having an incidence of 56.4%, while 43.6% were primiparas. Vaginal delivery occurred in 52.90% cases while caesarean section was done in 47.09% cases. CONCLUSIONThe present study confirms the higher association of breech presentation with multiparity. Various aetiological factors observed for breech presentation are -prematurity, oligohydramnios, polyhydramnios, placenta previa and foetopelvic disproportion. Perinatal morbidity and mortality was increased. Vaginal breech delivery is associated with increased perinatal morbidity and mortality than abdominal delivery. So, when the stakes are this much high one has to choose between the maternal risk of caesarean section and foetal risk of vaginal delivery to arrive at final decision.

A study of perinatal outcome in patients with breech presentation at tertiary care centre

“…13,15 Rana et al in their study showed that primi breech was the commonest indication for caesarean section (54.32%) followed by post caesarean section breech (14.81%) and bad obstetric history (9.8%). 10 Further, other indication for caesarean section were FPD 1.2%, foetal distress 7.4%, PIH 4.93% and placenta previa 7.4%. This study conducted in small populations.…”

“…Rana et al in their study reported that breech presentation was most common in 21-25 years age-group (44.76%) followed by 16-20 years (26.74%). 10 Similarly, Choudhary et al reported maximum breech (70.6%) in age-group 20-30 years. 11 In the present study, approximately 64.4% were primigravida and 35.6% were multigravida.…”

Etiological factors and maternal outcome in pregnancies with malpresentation: an observational study

“…Prematurity (28.48%) was reported as the commonest cause of breech in the study by Bhati RS, Choudhary SI. 3 The other causes were multiple gestation (6.83%), IUGR (4.80%), grand multiparity 4.07%, oligohydramnios (3.88%), anomalies of uterus (3.51%), polyhydramnios (2.40%), contracted pelvis (2.77%), placenta previa (1.66%), hydrocephalus (1.48%). In this study, the maximum number of the breech presentation delivered vaginally.…”