Vaginal breech births in a hospital where caesarean section is preferred for breech presentation

Abstract

Objectives. Caesarean section has become the preferred delivery method for breech presentation at Chris Hani Baragwanath Academic Hospital in Johannesburg. This study was done to determine the circumstances and outcomes of vaginal breech deliveries at the hospital.

Methods. Retrospective review of case files. Births of babies weighing ≥800 g, alive at onset of labour and without severe congenital anomaly were included.

Results. There were 90 vaginal breech deliveries. Twenty-six (28.8%) were not detected as breech on admission in labour, and 23 (25.6%) were booked for intended emergency caesarean section. Fifty-five deliveries (61.1%) were written up by registrars. In most cases there was no detail on delivery method and duration of delivery. There were 8 perinatal deaths, including 4 of babies weighing ≥2 500 g. All of the latter resulted from intrapartum hypoxia.

Conclusions. This study has shown that vaginal breech births continue to occur as unexpected events. Techniques for vaginal breech delivery remain essential skills for obstetric clinicians.