Caesarian delivery versus vaginal delivery and its impact on survival and morbidity for the full term single breech fetus A 5 years experience at Ain Shams University maternity hospital

Abstract

Breech presentation around 3-4% and cephalic presentation approximately 95%. In general population, incidence of breech presentation at preterm birth corresponds to incidence of breech presentation for this particular period of gestation when birth occurs (Hill,2008). The etiology for this mal-presentation remains largely elusive, although in approximately 20% of cases contributing factors may be found. These include prim-parity, multiple pregnancy, oligo- or poly-hydramnios, placental pathology, and certain fetal malformations (Cunningham et al., 2010). Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head (JOGC,2009). The reported incidence of birth injuries is about 2 and 1.1 percent in singleton vaginal deliveries of fetuses in a cephalic position and in cesarean deliveries, respectively. Injury may occur during labor, delivery, or after delivery, especially in neonates who require resuscitation in the delivery room (Alexander et al., 2006). Fetal presentation other than a vertex position, particularly breech presentation, is associated with an increase in the risk of birth injury with vaginal delivery. Delivery by cesarean section reduces the morbidity associated with vaginal delivery of breech infants (Hofmeyr, 2003). Caesarean section is the most common way to deliver a breech baby in Australia, the United Kingdom, and the United States. Like any major surgery, it involves risks