Outcomes associated with cesarean section versus vaginal breech delivery at a university hospital

Abstract

Objective: To determine whether vaginal breech delivery is associated with increased morbidity in term breech singletons using strict selection criteria. This study encompasses our previous studies (in 1987 and 1995) and extends our experience to 21 years.Study design: Retrospective cohort study from 1980 to 2001 including term, non-anomalous singleton breech deliveries selected by strict criteria. Univariable and multivariable analyses were performed for neonatal and maternal outcomes.Results: Five hundred and eleven women underwent cesarean section and 214 a trial of labor. We found greater overall maternal morbidity in the cesarean section group (odds ratio (OR) 1.89, 95% confidence interval (CI) ¼ 1.34-2.65). In the vaginal delivery group, neonates were more likely to have had >1 day of mechanical ventilation (OR 10.0, 95% CI ¼ 1. 56-63.9). No maternal deaths occurred and no neonatal deaths or seizures occurred.Conclusion: Given our findings, offering a trial of vaginal breech delivery to well-counseled strictly selected patients remains an appropriate option.

Planned vaginal breech delivery: current status and the need to reconsider

“…High-quality retrospective studies from various countries do not confirm the morbidity and mortality data from the TBT, provided that stringent criteria for breech delivery are applied for VBD [10]. The PREMODA study, published in 2006, was designed as a prospective observational study with an intention-to-treat analysis [11].…”

Current evidence in the management of previous caesarean section: clinical review

“…Serious maternal complications were similar in both groups, and ERCD increases the risk of only mild maternal complications [91,92]. However, a recent retrospective study by Hopkins et al comparing outcomes associated with caesarean and vaginal breech delivery found greater overall maternal morbidity in the caesarean group and no neonatal and maternal deaths in either groups [93]. External cephalic version can be an option in carefully selected patients [94].…”