engleski

A10 Outcome of term breech births: a 15-year experience

Objective: To review the short term and long term outcomes among singleton infants with breech presentation at term delivered over 15-year period. Design:retrospective, cohort study Setting: university Hospital Rijeka, Croatia, department of Gyn and Obst, Neonatology Institute Population: 1567 term breech infants alive at the onset of labour and born between January 1993 and december 2008 Methods: data abstracted from birth registers, neonatal discharge summaries and child health detabase system were used to compare the short and long term outcomes of singleton term breech infants born by two different modes of delivery (vaginal and pre-labour ceasarean section or cesarean section in labour). Fisher"s exact test was used to compare the categorical variables. Main outcome measures: Short term outcomes: perinatal mortality, Apgar score, admission to NICU, birth trauma and neonatal seizures. Long term outcomes:death during infancy, cerebral palsy, long term morbidity( development of special needs and special education needs). Results: Of 1056 ( 67.4%) were delivered vaginally and 511 ( 32.6%) were born by ceasarean section. In the second group 46 ( 9%) were born by ceasarean in labour and 465 ( 91%) were born by pre-labour ceasarean section. There were 2 ( 1.8%) non-malformed perinatal deaths among infants born by vaginal delivery compared with one (1.9%) in the ceasarean section group. Compared with infants born by pre-labour ceasarean section, those delivered vaginally or by ceasarean section in labour were significantly more likely to have low 5-minute Apgar scores ( 0.9%vs 5.9%, p<0.0001) and require admission to the NICU ( 1.6% vs 4%, p=0.01199. However, there was no significant difference in the long term morbidity between the two groups ( 5.3% in the vaginal delivery vs 3.8% in the ceasarean group, p=0.26) ; no difference in rates of cerebral palsy ; and non of the three infant deaths were related to the mode of delivery. Conclusions: Vaginal breech delivery or caeserean section in labour was associated with a small but unequivocal increase in the short term and morbidity, although the mortality was same in both groups.The long term outcome was not influenced by the mode of delivery.

vaginal breech delivery; outcome; mortality; morbidity

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