Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Outcomes associated with cesarean section versus vaginal breech delivery at a university hospital

Journal of Perinatology volume 27, pages 141–146 (2007)Cite this article

Abstract

Objective:

To determine whether vaginal breech delivery is associated with increased morbidity in term breech singletons using strict selection criteria. This study encompasses our previous studies (in 1987 and 1995) and extends our experience to 21 years.

Study design:

Retrospective cohort study from 1980 to 2001 including term, non-anomalous singleton breech deliveries selected by strict criteria. Univariable and multivariable analyses were performed for neonatal and maternal outcomes.

Results:

Five hundred and eleven women underwent cesarean section and 214 a trial of labor. We found greater overall maternal morbidity in the cesarean section group (odds ratio (OR) 1.89, 95% confidence interval (CI)=1.34–2.65). In the vaginal delivery group, neonates were more likely to have had >1 day of mechanical ventilation (OR 10.0, 95% CI=1.56–63.9). No maternal deaths occurred and no neonatal deaths or seizures occurred.

Conclusion:

Given our findings, offering a trial of vaginal breech delivery to well-counseled strictly selected patients remains an appropriate option.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Irion O, Hirsbrunner Almagbaly P, Morabia A . Planned vaginal delivery versus elective caesarean section: a study of 705 singleton term breech presentations. Br J Obstet Gynaecol 1998; 105: 710–717.

    Article  CAS  Google Scholar 

  2. Albrechtsen S, Rasmussen S, Reigstad H, Markestad T, Irgens L, Dalaker K . Evaluation of a protocol for selecting fetuses in breech presentation for vaginal delivery or cesarean section. Am J Obstet Gynecol 1997; 177: 586–592.

    Article  CAS  Google Scholar 

  3. Schiff E, Friedman S, Mashiach S, Hart O, Barkai G, Sibai B . Maternal and neonatal outcome of 846 term singleton breech deliveries: seven-year experience at a single center. Am J Obstet Gynecol 1996; 175: 18–23.

    Article  CAS  Google Scholar 

  4. Laros RK, Flanagan TA, Kilpatrick SJ . Management of term breech presentation: a protocol of external cephalic version and selective trial of labor. Am J Obstet Gynecol 1995; 172: 1916–1925.

    Article  Google Scholar 

  5. Brown L, Karrison T, Cibils L . Mode of delivery and perinatal results in breech presentation. Am J Obstet Gynecol 1994; 171: 28–34.

    Article  CAS  Google Scholar 

  6. Cook H . Experience with external cephalic version and selective vaginal breech delivery in private practice. Am J Obstet Gynecol 1993; 168: 1886–1890.

    Article  CAS  Google Scholar 

  7. Flanagan TA, Mulchahey KM, Korenbrot CC, Green JR, Laros RK . Management of term breech presentation. Am J Obstet Gynecol 1987; 156: 1492–1502.

    Article  CAS  Google Scholar 

  8. Gimovsky ML, Wallace RL, Schifrin BS, Paul RH . Randomized management of the nonfrank breech presentation at term: a preliminary report. Am J Obstet Gynaecol 1983; 146: 34–40.

    Article  CAS  Google Scholar 

  9. Green J, McLean F, Smith LP, Usher R . Has an increased cesarean section rate for term breech delivery reduced the incidence of birth asphyxia, trauma, and death? Am J Obstet Gynecol 1982; 142: 643–648.

    Article  CAS  Google Scholar 

  10. Graves W . Breech delivery in twenty years practice. Am J Obstet Gynecol 1980; 137: 229–234.

    Article  CAS  Google Scholar 

  11. Collea JV, Chein C, Quilligan EJ . The randomized management of term frank breech presentation: a study of 208 cases. Am J Obstet Gynecol 1980; 137: 235–244.

    Article  CAS  Google Scholar 

  12. Rovinsky JJ, Miller JA, Kaplan S . Management of breech presentation at term. Am J Obstet Gynecol 1973; 115: 497–513.

    Article  CAS  Google Scholar 

  13. Roman J, Bakos O, Cnattingius S . Pregnancy outcomes by mode of delivery among term breech births: Swedish experience 1987–1993. Obstet Gynecol 1998; 92: 945–950.

    CAS  PubMed  Google Scholar 

  14. Gifford DS, Morton SC, Fiske M, Kahn K . A meta-analysis of infant outcomes after breech delivery. Obstet Gynecol 1995; 85: 1047–1054.

    Article  CAS  Google Scholar 

  15. Cheng M, Hannah ME . Breech delivery at term: a critical review of the literature. Obstet Gynecol 1993; 82: 605–618.

    CAS  PubMed  Google Scholar 

  16. Krebs L, Topp M, Langhoff-Roos J . The relation of breech presentation at term to cerebral palsy. Br J Obstet Gynaecol 1999; 106: 943–947.

    Article  CAS  Google Scholar 

  17. Faber-Nijholt R, Huisjes HJ, Touwen BCL, Fidler VJ . Neurological follow-up of 281 children born in breech presentation: a controlled study. BMJ 1983; 286: 9–12.

    Article  CAS  Google Scholar 

  18. Rosen MG, Debanne S, Thompson K, Bilenker RM . Long-term neurological morbidity in breech and vertex births. Am J Obstet Gynecol 1985; 151: 718–720.

    Article  CAS  Google Scholar 

  19. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR . Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Lancet 2000; 356: 1375–1383.

    Article  CAS  Google Scholar 

  20. ACOG. Mode of Term Singleton Breech Delivery. ACOG Committee on Obstetric Practice Opinion Number 265. ACOG: Washington DC, 2001.

  21. van Roosmalen J, Rosendaal F . There is still room for disagreement about vaginal delivery of breech infants at term. Br J Obstet Gynaecol 2002; 109: 967–969.

    Article  Google Scholar 

  22. Christian SS, Brady K, Read JA, Kopelman JN . Vaginal breech delivery: a five-year prospective evaluation of a protocol using computed tomographic pelvimetry. Am J Obstet Gynecol 1990; 163 (3): 848–855.

    Article  CAS  Google Scholar 

  23. Gimovsky ML, O’Grady JP, Morris B . Assessment of computed tomographic pelvimetry within a selective breech presentation management protocol. J Reprod Med 1994; 39 (7): 489–491.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Funding Source: Not applicable.

Author information

Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA

    L M Hopkins, T Esakoff, M S Noah, G F Sawaya & R K Laros Jr

  2. San Francisco Perinatal Associates, San Francisco, CA, USA

    M S Noah

  3. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    D H Moore

Authors
  1. L M Hopkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T Esakoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M S Noah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. D H Moore
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G F Sawaya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R K Laros Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L M Hopkins.

Additional information

Abstract presented in poster format at the 51st Annual Meeting of the American College of Obstetricians and Gynecologists, April 2003.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hopkins, L., Esakoff, T., Noah, M. et al. Outcomes associated with cesarean section versus vaginal breech delivery at a university hospital. J Perinatol 27, 141–146 (2007). https://doi.org/10.1038/sj.jp.7211615

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211615

Keywords

This article is cited by

Search

Advanced search

Quick links