Monday, March 24, 2008

Planned Vaginal Delivery Viable for Early Preterm Breech Delivery

Source: American Journal of Obstetrics & Gynecology 2008; 198: 289.e1-e6
Comparing neonatal death rates in preterm singleton breech deliveries in centers with either a policy of planned vaginal delivery or planned cesarean delivery.

MedWire News: Planned vaginal delivery for preterm fetuses in the breech presentation is no more likely to lead to neonatal death than planned cesarean delivery, study findings show.

Gilles Kayem (University Paris XII, Créteil, France) and colleagues compared rates of neonatal death for preterm singleton breech deliveries in three perinatal centers. Planned vaginal delivery was standard policy at two of these centers, while planned cesarean delivery was the standard policy at the third.

A total of 169 women participated in the study, of whom 84 delivered under planned vaginal delivery policies and 85 under planned cesarean delivery policies.

The researchers note, however, that vaginal deliveries were necessary for 5.9 percent of women undergoing planned cesarean deliveries, while cesarean deliveries were necessary for 49.0 percent of those with planned vaginal deliveries.

Overall, the rate of neonatal death was similar in both groups of women, at 10.7 percent for women with planned vaginal deliveries and 7.1 percent for those with planned cesareans.

Factors significantly and independently associated with neonatal death were preterm premature rupture of membranes before 24 weeks of gestation (odds ratio [OR] = 13.3), head entrapment (OR = 7.2), and gestational age between 26 weeks and 27 weeks and 6 days of gestation (OR = 4.7).
"Risk of neonatal death was not associated with any particular policy of mode of delivery," the researchers conclude.

Posted: 20 March 2008
(c) 2008 Current Medicine Group Ltd, a part of Springer Science+Business Media

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