PLD.11 Characteristics of successful vaginal breech deliveries: A retrospective observational study in a tertiary centre

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Abstract

Objectives

Firstly, to assess the incidence of vaginal breech deliveries within a tertiary obstetric unit. Secondly to determine obstetric characteristics and thirdly, the maternal and fetal outcomes of this population over an 11-year period following the publication of the ‘Term breech trial’.

Methods

A retrospective observational study of prospectively gathered data on vaginal breech deliveries over an 11-year period from 2001 to 2011 at a large tertiary referral obstetric centre. The delivery of still-born infants and those with lethal congenital anomalies were excluded. Data analysis was performed through Microsoft Excel.

Results

Our study included 2,346 term breech deliveries over the study period. The rate of vaginal breech deliveries was 5% (119/2346). 76.5% of cases occurred in multiparous patients (91/119) p < 0.05 and in 38.7% of cases delivery occurred beyond 40 completed weeks gestation (46/119) and was associated with rapid labour progression (39.5% <60 min (47/119)). The patient required an episiotomy for delivery in 52.1% of cases (62/119). Of infants delivered, 3.3% were macrosomic (4/119). 4.2% had an Apgar of <7 at 5 minutes (5/119) and cord pH level was <7.0 in 3.3% of cases (4/119).

Conclusion

Vaginal breech deliveries are more likely to occur in multiparous women who have relatively short duration of labour. The maternal and fetal outcomes are overall reassuring.

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