Mode of vaginal delivery in breech presentation and perinatal outcome

Ginekol Pol. 2021 Sep 20. doi: 10.5603/GP.a2021.0183. Online ahead of print.

Abstract

Objectives: To compare a perinatal outcome in breech presentation depending on different modes of vaginal breech delivery (VBD).

Material and methods: Over the course of 13 years (2005-2018), perinatal outcome of newborns was compared among 98 singleton pregnancies (64 term pregnancies and 34 preterm pregnancies) completed with VBD divided into six groups depending on the mode of delivery used (Bracht, Müller, Thiessen, classical arm release, Mauriceau-Levret-Veit-Smellie (MLVS), and Vermelin´s spontaneous vaginal delivery). Also, maternal demographic parameters were observed.

Results: Of 98 singleton pregnancies, the most frequently used mode was Thiessen (35.71%), followed by MLVS technique (25.51%), Bracht (22.45%), Vermelin (13.27%), classical arm release (2.04%) and Müller (1.02%). Newborns with Apgar score ≤ 7 at 5 min. were transferred to the neonatal intensive care unit (NICU), which included 15.31% of newborns (total 15 newborns: 1 term and 14 preterm newborns). The incidence of episiotomy was 63.27%. Seventy-point five percent of women included in the study were ≤ 35 years of age, and 37.76% were multiparas. Delivery was induced in 7.14% cases.

Conclusions: Less- traumatizing actions during VBD have less harmful consequences and better perinatal outcome. Lower Apgar score was noted with the aggressiveness of the mode of VBD.

Keywords: breech presentation; delivery mode; perinatal outcome; vaginal delivery.