Outcome of breech deliveries in Aminu Kano Teaching Hospital, Kano State, Nigeria: A 2-year study

Abstract

Breech presentation is defined as polar alignment of fetus in which the fetal buttocks or feet present at the maternal pelvic inlet. Breech is the most common malpresentation in pregnancy, incidence is high before term but occur in 3-4% of term pregnancies. There is increased perinatal morbidity and mortality with breech presentation which has been linked to the prematurity, birth asphyxia due to cord accidents, congenital abnormalities, birth trauma and mode of delivery. This study was aimed at determining the incidence and outcome of breech deliveries at Aminu Kano Teaching Hospital, Nigeria. It was a retrospective analysis of breech deliveries at Aminu Kano Teaching Hospital over a 2-year period. Information was obtained from the labor ward register, theatre register and the case notes of the mothers. There were 6658 deliveries during the period of the study, out of which 154 had breech deliveries. The incidence of breech deliveries during the period under study was 2.31%. The age of the patients ranged from 17-45 years. Parity ranged between 0-11. There were more breech deliveries in the multipara (59.5%) than in primigravidae (14.9%) and primipara (25.6%).However, there was no significant difference in the perinatal outcome between the groups (P=0.054). Deliveries were mostly through caesarean section (62%), while 38% were through assisted vaginal breech. There were 113 live births and 8 still births. This study has shown that the incidence of breech is slightly lower than in many studies, and breech deliveries were mostly unplanned and more among multiparae. The neonatal outcomes in the planned breech deliveries were excellent. Birth asphyxia and stillborn were found more in the unplanned and unbooked cases with breech.