Preterm breech presentation: A comparison of intended vaginal and intended cesarean delivery

Lester Bergenhenegouwen, Floortje Vlemmix, Sabine Ensing, Jelle Schaaf, Joris Van Der Post, Ameen Abu-Hanna, Anita C J Ravelli, Ben W. Mol, Marjolein Kok

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17 Citations (Scopus)

Abstract

OBJECTIVE: To study the association of the intended mode of delivery and perinatal morbidity and mortality among breech fetuses who are delivered preterm. METHODS: We conducted a nationwide cohort study of women with a singleton pregnancy in breech presentation who delivered preterm (26 0/7-36 6/7 weeks of gestation) in the years 2000-2011. We compared perinatal outcomes according to the intended and actual mode of delivery using multivariate logistic regression analysis. We performed subgroup analyses of gestational age and parity. RESULTS: We studied 8,356 women with a preterm singleton breech delivery. Intended cesarean delivery (n1,935) was not associated with a significant reduction in perinatal mortality compared with intended vaginal delivery (n6,421) (1.3% compared with 1.5%; adjusted odds ratio [OR] 0.97, 95% confidence interval [CI] 0.60-1.57). However, the composite of perinatal mortality and morbidity was significantly reduced in the intended cesarean delivery group (8.7% compared with 10.4%; adjusted OR 0.77, 95% CI 0.63-0.93). In the subgroup of women delivering at 28-32 weeks of gestation, intended cesarean delivery was associated with a 1.7% risk of perinatal mortality compared with 4.1% with intended vaginal delivery (adjusted OR 0.27, 95% CI 0.10-0.77) and significantly reduced composite mortality and severe morbidity, 5.9% compared with 10.1% (adjusted OR 0.37, 95% CI 0.20-0.68). CONCLUSION: In women delivering a preterm breech fetus, cesarean delivery is associated with reduced perinatal mortality and morbidity.

Original languageEnglish
Pages (from-to)1223-1230
Number of pages8
JournalObstetrics and Gynecology
Volume126
Issue number6
DOIs
Publication statusPublished - 1 Dec 2015

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Bergenhenegouwen, L., Vlemmix, F., Ensing, S., Schaaf, J., Van Der Post, J., Abu-Hanna, A., ... Kok, M. (2015). Preterm breech presentation: A comparison of intended vaginal and intended cesarean delivery. Obstetrics and Gynecology, 126(6), 1223-1230. https://doi.org/10.1097/AOG.0000000000001131