Management trend and safety of vaginal delivery for term breech fetuses in a tertiary care hospital of Karachi, Pakistan
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Nuruddin Badruddin Mohammed
Abstract
Aim: To investigate the safety of vaginal delivery for term breech fetuses in a tertiary-care hospital of Pakistan.
Methods: We reviewed the medical records of all live singleton breech deliveries at or beyond 37 weeks of gestation, at the Aga Khan University Hospital, Karachi, from January 1988 to December 1995.
Results: Rate of cesarean section increased from 48% (1988) to 74% (1995). Out of 287 subjects, 158 underwent elective cesarean section while 129 received a trial of labor, 77% of which delivered vaginally. There was no neonatal or maternal death. Compared to babies delivered by emergency or elective cesarean section, those delivered vaginally had significantly more neonatal intensive-care unit admissions (none and 5% versus 13 %) and higher rates of birth trauma (none and 0.6% versus 7%). However, there was no significant difference in the Apgar score at 5 minutes and the risk of maternal complications by delivery mode.
Conclusion: Allowing trial of labor to carefully selected mothers can result in vaginal delivery in 77% of the cases. However, the risk of trauma and neonatal intensive-care unit admissions, among vaginal births may favor the decision of elective cesarean section, unless rigorous pre-delivery assessment and conduct of delivery by adequately trained obstetricians is performed.
Copyright © 2001 by Walter de Gruyter GmbH & Co. KG
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- Perinatal Medicine in Developing Countries
- TUZLA STATEMENT
- Perinatal problems in developing countries: lessons learned and future challenges
- Antenatal care in developing countries. What should be done?
- A simple, efficient and inexpensive program for preventing prematurity
- The use of first trimester ultrasound in routine practice
- Antepartal assessment of IUGR fetuses
- Genetic components of perinatal morbidity and mortality
- Eclampsia: a leading cause of maternal mortality
- Hemostatic problems before, during and after delivery
- Perinatal mortality in the Federation of Bosnia and Herzegovina
- Management trend and safety of vaginal delivery for term breech fetuses in a tertiary care hospital of Karachi, Pakistan
- Post-partum hysterectomies: revisited
- Sex ratio imbalance and Down’s syndrome newborns
- Congress Calendar
Articles in the same Issue
- Perinatal Medicine in Developing Countries
- TUZLA STATEMENT
- Perinatal problems in developing countries: lessons learned and future challenges
- Antenatal care in developing countries. What should be done?
- A simple, efficient and inexpensive program for preventing prematurity
- The use of first trimester ultrasound in routine practice
- Antepartal assessment of IUGR fetuses
- Genetic components of perinatal morbidity and mortality
- Eclampsia: a leading cause of maternal mortality
- Hemostatic problems before, during and after delivery
- Perinatal mortality in the Federation of Bosnia and Herzegovina
- Management trend and safety of vaginal delivery for term breech fetuses in a tertiary care hospital of Karachi, Pakistan
- Post-partum hysterectomies: revisited
- Sex ratio imbalance and Down’s syndrome newborns
- Congress Calendar
