Higher Mortality Tied to Planned Vaginal Breech Delivery
(HealthDay News) — Perinatal mortality and morbidity is significantly higher with planned vaginal breech delivery compared with planned cesarean delivery, according to a review published online July 29 in BJOG: An International Journal of Obstetrics & Gynaecology.
Yifru Berhan, MD, of the Hawassa University College, and Abraham Haileamlak, MD, of the Jimma University College of Public Health and Medicine – both in Ethiopia, conducted a systematic literature review (1993–2014) and meta-analysis to compare the absolute and relative risks of perinatal mortality and morbidity associated with planned vaginal delivery and planned cesarean section for delivery in term singleton breech presentations. Twenty-seven articles with 258,953 women were included.
The researchers found that the relative risk of perinatal mortality and morbidity was two- to five-fold higher with planned vaginal vs. planned cesarean delivery. In the planned vaginal delivery group the absolute risk was 0.3% for perinatal mortality, 0.7% for fetal neurologic morbidity, 0.7% for birth trauma, 2.4% for 5-minute Apgar score <7, and 3.3% for neonatal asphyxia.
"Even taking into account the relatively low absolute risks of vaginal breech delivery, the current study substantiates the practice of individualized decision-making on the route of delivery in a term breech presentation," the authors write.