Riffat Jaleel, Ayesha Khan, Shagufta Mujtaba, Abida Bibi.
Unplanned Vaginal Birth of Singleton Breech Presentation at Term.
J Surg Pak Jan ;20(4):142-6.

Objective: To determine the perinatal outcome in unplanned term breech vaginal deliveries. Study design: Descriptive case series. Place & Duration of study: Department of Obstetrics and Gynaecology Unit I, Dow Medical College and Civil Hospital, Dow University of Health Sciences Karachi, from November 2014 to October 2015. Methodology: Data of all the women with singleton pregnancy and breech presentation, gestational age between 37 to 41 weeks, who underwent breech vaginal delivery, were collected. Variables studied included maternal age, parity, gestational age, type of breech, reason for conducting breech vaginal delivery, maternal complications, neonatal status and complications. Results: Total births during the study period were 3,932. Total patients presenting with breech were 172 (4.37%) and those presenting at term were 143 (3.6%). Out of these, 54 (37.8%) patients underwent breech vaginal delivery. Overall frequency of breech vaginal delivery of patients at term was 1.37%. Mean maternal age was 26.87 year, majority were multiparous and none was beyond 40 weeks of gestation. There were no maternal complications in 48 (88.9%) patients. Mean birth weight of newborn was 2.75 kg and 63% were females. Eight babies were born dead, of whom 7 arrived with absent fetal heart sounds. The 5 minute APGAR score was less than 7 in 22% cases. There were two neonatal deaths in this group. Conclusions: Fifty-four breech vaginal births were conducted during the study period. Skills related to vaginal birth in breech presentation must be learned by all those who manage pregnant women.

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