Breech delivery before and after the term breech trial recommendation

OBJECTIVE: To compare the outcome of breech delivery at term in women before and after the term breech trial (TBT) recommendation.

METHODS: A retrospective study carried out at Abha Maternity Hospital, Abha, Kingdom of Saudi Arabia comprising 796 women with breech presentation at term who delivered at our hospital between May 1997 and February 2005 divided into 2 groups. Group 1 consisted of 394 patients who were delivered 4 years before the recommendation of the TBT, and group 2 comprised 402 patients delivered 4 years after the recommendation.

RESULTS: There were no statistically significant differences between the 2 groups with regards to the mean maternal age and birth weight, p>0.05, however, parity, gestational age at delivery, booking status, and cesarean section (CS) rate reached statistically significant levels, p<0.05. Assisted vaginal delivery was conducted in 106 (26.9%) of patients in group 1 and 69 (17.1%) in group 2, this also was statistically significant. No statistically significant differences were found between the 2 groups regarding the perinatal mortality, low Apgar score, <7 at 5 minutes and complications during delivery, p>0.05.

CONCLUSION: There was a dramatic increase in the rate of CS without a corresponding improvement in the neonatal outcome in the years following the TBT recommendation in our hospital. We suggest that the policy is formulated to reduce the number of unbooked patients with breech presentation at term in our community to reduce the CS rate in these groups of patients.