Audit of Singleton Breech Deliveries at Adeoyo Maternity Hospital: A 5-Year Review
Main Article Content
Abstract
Introduction: Breech presentation poses obstetric challenges, and the optimal mode of delivery remains debated. Most breech deliveries are unplanned and occur in advanced labour, contributing to adverse perinatal outcomes. This study assessed the incidence, mode of delivery, and outcomes of singleton breech deliveries at Adeoyo Maternity Teaching Hospital (AMTH), southwest Nigeria
Methods: A retrospective review of all singleton breech deliveries at AMTH from January 2012 to December 2016 was conducted. Data on maternal age, parity, booking status and Apgar scores extracted from labour ward records. Analysis was performed using SPSS version 20.
Results: Of 17,339 deliveries during the study period, 272 were singleton breech, yielding an incidence of 1.6%. Maternal ages ranged 16–45 years, with 57.7% aged 25–34 years. The incidence of breech delivery increased with parity, being 42.3% among nulliparous and 50% among women with 2–4 children. Most patients (71%) were booked. Vaginal deliveries accounted for 79%, and caesarean section for 21%. There were 220 (80.9%) live births, 33 (12.1%) fresh stillbirths, and 19 (7%) macerated stillbirths. Apgar scores ≥7 at 5 minutes were more frequent following caesarean delivery.
Conclusion: Singleton breech delivery was uncommon, with vaginal delivery predominating. Caesarean section was associated with better immediate neonatal outcomes, highlighting the importance of careful case selection and skilled attendance in breech deliveries to optimize perinatal outcomes.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Tunau K, Ahmed Y. Breech deliveries in Usmanu Danfodiyo University Teaching Hospital Sokoto, Northwestern Nigeria: a 10-year review. Sahel Med J. 2013;16:52-5.
Kish K. Malpresentation and cord prolapse. In: DeCherney AH, Nathan L, Laufer N, Roman AS, editors. Current Diagnosis and Treatment. New York: McGraw-Hill; 2013. p. 317-33.
Dutta DC. Malposition, malpresentation and cord prolapse. In: Konar H, editor. Textbook of Obstetrics. Kolkata: New Central Book Agency (P) Ltd; 2011. p. 374-98.
Jido TA, Oubu JAM. Abnormal presentation. In: Agboola A, editor. Textbook of Obstetrics and Gynaecology for Medical Students. 2nd ed. Heinemann Educational Books (Nigeria) Plc; 2006. p. 417-22.
Abasiattai AM, Bassey EA, Etuk SJ, Udoma EJ, Ekanem AD. Caesarean section in the management of singleton breech delivery in Calabar, Nigeria. Niger J Clin Pract. 2006;9:22-5.
Olayemi A, Odukogbe A, Omigbodun A, Odeyemi AS. Effect of caesarean section on the perinatal outcome in singleton breech deliveries in Ibadan. Niger J Clin Pract. 2002;5:41-4.
John CT, Okpani AOU. Breech presentation. In: Kwawukume EY, Ekele BA, Danso KA, Emuveyan EE, editors. Comprehensive Obstetrics in the Tropics. 2nd ed. Accra: Assemblies of God Literature Centre Ltd; 2015. p. 202-6.
Arulkumaran S. Malpresentation, malposition, cephalopelvic disproportion and obstetric procedures. In: Edmond K, editor. Dewhurst's Textbook of Obstetrics and Gynaecology. 8th ed. Chichester, UK: Blackwell Science; 2007. p. 213-26.
Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR, et al. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomized multicenter trial. Lancet. 2000;356:1375-83.
Kahansim ML, Changkat LL, Eya AE. Breech deliveries in a secondary health-care facility in South-South Nigeria. Trop J Obstet Gynaecol. 2016;33:274-8.
Whyte H, Hannah ME, Saigal S, Hannah WJ, Hewson W, Amangkwah K, et al. Outcome of children at 2 years after planned caesarean versus planned vaginal birth for breech presentation at term: the international randomized Term Breech Trial. Am J Obstet Gynecol. 2004;191:864-71.
Visser GH, Rietberg CC, Oepkes D, Vandenbussche FP. Breech presentation: infant versus mother. Ned Tijdschr Geneeskd. 2005;149:2211-4.
Keirse MJ. Evidence-based childbirth only for breech babies? Birth. 2001;29:55-9.
Hauth JC, Cunningham FG. Vaginal breech delivery is still justified. Obstet Gynecol. 2002;99:1115-6.
Kotaska A. Inappropriate use of randomized trials to evaluate complex phenomena: case study of vaginal breech delivery. BMJ. 2004;329:1039-42.
Goffinet F, Carayol M, Foidart JM, Alexander S, Uzan S, Subtil D, et al. Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Obstet Gynecol. 2006;194:1002-11.
Bako AU, Audu LI. Undiagnosed breech in Zaria, Nigeria. J Obstet Gynaecol. 2000;20:148-50.
Hofmeyr GJ, Kulier R. External cephalic version for breech presentation at term (Review). Chichester, UK: The Cochrane Library, John Wiley & Sons Ltd.; 2006.
Onah HE, Know PO. External cephalic version: a survey of current practice among Nigerian obstetricians. Trop J Obstet Gynaecol. 2004;21:24-6.
Takai IU, Kwayabura AS, Bukar M, Idrissa A, Obed JY. A 5-year retrospective review of singleton, term breech deliveries seen at a tertiary hospital in northern Nigeria. Arch Int Surg. 2016;6:7-11.
Olatunji AO, Sule-Odu AO. Term breech delivery at a university hospital in Nigeria. Niger Postgrad Med J. 1999;6:171-4.
Gaikwad S, Rokade R, Banerjee G. A study of maternal and perinatal outcome of breech presentation in vaginal and operative deliveries in a university hospital. MedPulse Int Med J. 2014;1:252-8.
Duke AO, Duke CO, Onyegbule OA, Amajuoyi CC, Madu PI, Enyinnaya EB. Outcome of single breech term deliveries at the Federal Medical Centre, Owerri, South Eastern Nigeria: a five-year review. Int J Res Med Sci. 2014;2:527-31.
Ojiyi EE, Dike EI, Okeudo C, Anolue FC, Uzoma O, Uzoma MJ, et al. Outcome of singleton term breech deliveries at a university teaching hospital in Eastern Nigeria. WebmedCent Obstet Gynaecol. 2011;2:WMC002543.
Pradeep MR, Shivanna L. Route of delivery for term breech presentation: comparative analysis. J Dent Med Sci. 2014;13:1-4.
Adeyemi AS, Adekanle DA, Afolabi AF, Fadero FF. Outcome of breech deliveries at a tertiary health institution in southwestern Nigeria. Niger Hosp Pract. 2011;7:3-7.
Nalliah S, Loh KY, Japaraj RP, Mukudan K. Is there a place for selective vaginal breech delivery in Malaysian hospitals: experiences from the Ipoh Hospital? J Matern Fetal Neonatal Med. 2009;22:129-36.
Shittu SA, Fasubaa OB, Dare FO, Ogunniyi OS. Five-year review of breech presentation at Ile-Ife, Nigeria. Trop J Obstet Gynaecol. 2001;18:36.