The incidence and perinatal outcomes of singleton vaginal breech deliveries in a low-resource setting, mpilo central hospital, Bulawayo, Zimbabwe

Abstract

Background: Vaginal breech deliveries are becoming less and less in obstetric units since the publication of the Term Breech Trial in 2000. There are less and less training opportunities for trainees in the specialty. Simulation training could never be as good as having real experience of vaginal breech deliveries. Consequently, many clinicians are now less confident in dealing with vaginal breech deliveries. The objective of this study was to document the incidence and perinatal outcomes of singleton vaginal breech deliveries in a low-resource setting. Methods: This was a retrospective descriptive study covering the period between 1 January 2017 and 31 December 2017 in a tertiary teaching hospital. A paper data collection sheet was used to collect the information. All singleton babies >24 weeks gestation born by vaginal breech delivery at the labour ward were included in the study. The data was then analysed. Results: The incidence of singleton vaginal breech deliveries 0.66%. Teenage mothers accounted for 10.7%. 21.4% of women were unbooked. 76.8% were live deliveries and 23.2% were stillborn, and there was a statistical difference between the two groups, P=0.05. Of the live births, 51.2% had 1 minute Apgar score of <7. By 5 minute 32.6% still had Apgars scores <7. 98.2% of mothers had no complications post delivery, with only 1 case of PPH, P=0.025. Conclusions: The incidence of all singleton vaginal breech deliveries 0.66% and only 0.05% for term breech. Of the live births, more than half had low 1 minute Apgar score of <7. The vast majority mothers had no complications post-delivery.

Evaluating the factors influencing perinatal outcome in breech presentation

“…In a study, of the live births among the vaginal breech deliveries, 51.2% had 1-minute Apgar score of <7. 7 Perinatal mortality was marginally higher in the multiparous patients as most of them delivered vaginally (Table 2).…”