Impact on Maternal and Neonatal Outcome of Caesarean Section and Vaginal Delivery in Breech Presentation

Background: Breech presentation is always at a greater risk than Cephalic presentation with respect to perinatal morbidity and perinatal mortality. Research Question : effects of Caesarean section and vaginal delivery on perinatal and maternal mortality and morbidity in breech presentation? Material and Methods: One hundred cases with breech presentation that have undergone delivery (Caesarean / Vaginal) were included in the study. Study Design: Analytic study. Setting: Hospital based. Study Variables: birth weight, mode of delivery, Apgar score. Statistical Analysis: Chi-square test, simple proportion. Results: All babies with Apgar score less than 5 died .Only 5 babies with Apgar score between 5-7 died .100 % of the babies with Apgar score more than 7 were alive at the end of first post natal week. There were higher percentages of babies with low Apgar scores in vaginal delivery as compared to C-section babies. Perinatal mortality rate for C-section was 2.18 % in comparison to their counterparts, 39.62 % in vaginal delivery. These results were highly significant. Of the total 22 perinatal deaths, 18 were premature constituting 81.18%. There was no maternal mortality. In the present study there was 14.9%maternal morbidity associated with C-section as compared to 7.5 %with vaginal delivery. Conclusion: Thus prematurity was the most important factor towards perinatal mortality in breech presentation. This shows that the breech baby is likely to be benefited by Csection and morbidity from trauma and asphyxia can be reduced by the mere liberal use of C-section in selected cases. The authors recommended Csection for all breech presentation with expected birth weight above 3000 g.