Higher mortality tied to planned vaginal breech delivery

(HealthDay)—Perinatal mortality and morbidity is significantly higher with planned vaginal breech delivery compared with planned cesarean delivery, according to a review published online July 29 in BJOG: An International Journal of Obstetrics & Gynaecology.

Yifru Berhan, M.D., of the Hawassa University College, and Abraham Haileamlak, M.D., of the Jimma University College of Public Health and Medicine—both in Ethiopia, conducted a systematic literature review (1993 to 2014) and meta-analysis to compare the absolute and relative risks of perinatal mortality and morbidity associated with planned vaginal delivery and planned cesarean section for delivery in term singleton breech presentations. Twenty-seven articles with 258,953 women were included.

The researchers found that the relative risk of perinatal mortality and morbidity was two- to five-fold higher with planned vaginal versus planned cesarean delivery. In the planned vaginal delivery group the absolute risk was 0.3 percent for perinatal mortality, 0.7 percent for fetal neurologic morbidity, 0.7 percent for birth trauma, 2.4 percent for 5-minute Apgar score <7, and 3.3 percent for neonatal asphyxia.

"Even taking into account the relatively low absolute risks of vaginal breech delivery, the current study substantiates the practice of individualized decision-making on the route of delivery in a term breech presentation," the authors write.