Delivery planning: a contamporary approach to breech presentation in obstetrics

Abstract

The world data on stable perinatal losses in breech presentation and a significant increase in the number of cesarean deliveries (70–80%) have led to a search for fundamentally new approaches to breech deliveries. The objective: the aim of the research is to evaluate the effectiveness and the validity of individual delivery planning for breech presentations. Materials and methods. Pregnant patients were divided into two groups: 1) the main group (MG) (n=36) which included women with planned conservative deliveries for breech presentations; 2) the control group (CG) (n=33) which included women with planned cesarean deliveries for breech presentations. Results. Pregnancy completion in the majority of patients from both groups occurred in the planned way: MG – 27 (75%), CG – 29 (87.8%). The MG patients gave birth in the all-fours position – 11 (40.7%) and with the help of the Tsoyanov method – 16 (53.9%). There were 9 (25%) cases of cesarean deliveries in the CG which were mainly classified as the 1st urgency category – 5 (55.5%). The need for urgent cesarean section in the CG occurred in half as many cases – 4 (12.2%) and most cases – 3 (75%) – had the 3rd urgency category. Perinatal complications were more common among the children from the CG who had received manual help at birth: birth trauma – 8 (22.2%), asphyxia – 3 (8.3%), aspiration – 2 (5.55%), hypoxic-ischemic brain damage – 3 (8.3%). Conclusion. The presented data indicate the lack of highly professional skills which require thorough execution and improvement of obstetrical manipulations by obstetricians and gynecologists. Key words: breech position, conservative delivery, cesarean section, perinatal outcomes.