Neonatale uitkomst na een in opzet vaginale bevalling bij aterme stuitligging: geen verband met pariteit of geboortegewicht, maar wel meer geboorteletsels dan bij primaire keizersnede

To investigate if in a planned vaginal breech delivery parity or birthweight is associated with neonatal outcome.

Design

Retrospective analysis of local data from the National Obstetric Registration of the Netherlands.

Method

The study concerned outcomes of 516 births of singletons with breech presentation after pregnancies > 37 weeks in the period 1 January 1995 to 31 December 1999 at the Medical Centre Leeuwarden, the Netherlands; there were 448 planned vaginal breech deliveries. Nulliparous and multiparous were separately studied in four birthweight groups (< 3000 g, 3000-3499 g, 3500-3999 g and ≥ 4000 g).

Results

None of the neonates born by primary caesarean experienced birth trauma. In the group with planned vaginal breech delivery 2 of the neonates of nulliparous and 3 of multiparous mothers experienced neonatal morbidity. There was one case of perinatal mortality due to birth trauma (0.2). The total perinatal morbidity was 6 with no differences between nulliparae and multiparae and between the birthweight groups. In nulliparous, the percentage of emergency caesarean sections rose from 20 in the < 3000 g birthweight group to 62 in the ≥ 4000 g birthweight group.

Conclusion

Following a planned vaginal breech delivery, no differences were observed in neonatal outcome between nulliparous and multiparous women and between the four birthweight groups. The extent to which the figures were influenced by the selection for primary caesarian section is not clear.