[Breech presentation: vaginal delivery or planned caesarean section?]. / Presentation de siege: accouchement par voie basse ou cesarienne systematique?

ABSTRACT

UNLABELLED Breech delivery is a high risk situation because of its numerous dystocies. The most serious is the last head retention. The authors realized a retrospective study concerning 347 patients who had given birth to a newborn child in breech presentation during a period of 4 years. RESULTS: The vaginal delivery was associated in a significant way to an excess of obstetric traumatisms (5.5%) versus caesarean section (0.5%) and this even after strict selection of vaginal delivery's conditions (P = 0.00453). The rate of the newborn child having Apgar's score < 7 in 5 min was higher in case of vaginal delivery (17.39%) than caesarean section's birth (3.48%). Corrected neonatal mortality is higher in the group of vaginal delivery than caesarean section's group (34% versus 0.49%, P = 0.02553). There is no significant difference of maternal morbidity between caesarean section and vaginal delivery group (P = 4.65). Vaginal delivery is associated to an excess of morbidity and neonatal mortality even after strict selection of the candidates of the vaginal delivery.