Caesarean section in the management of singleton breech delivery in Calabar, Nigeria

Abstract

Objective: To establish the role of Caesarean section in reducing perinatal mortality following singleton breech delivery in the University of Calabar Teaching Hospital, Calabar.

Method: The case notes of all patients who had singleton breech delivery between 1st January 1991 and 31st December 2000 were studied.

Results: The incidence of singleton breech delivery was 1.4% and 37.1% of the breech deliveries were by Caesarean section. Feto-pelvic disproportion and footling breech presentation were the most common indications for Caesarean section (50.0%). Most of the breeches delivered by emergency Caesarean section (55.0%) were in unbooked patients while the booked ones were mostly delivered by elective Caesarean section (80.0%). There was a statistically significant decrease in perinatal mortality in primigravid breeches ((p=0.018) and in fetuses estimated to weigh above 3.5 kilograms (p=0.0005) following Caesarean section.

Conclusion: This study shows that Caesarean section plays a very important role in the management of breech presentation in our environment. We advocate elective Caesarean section of all primigravid breeches and those whose fetuses are estimated to weigh above 3.5 kilograms.

Keywords: Singleton breech delivery, Caesarean section, perinatal mortality

Nigerian Journal of Clinical Practice Vol. 9(1) 2006: 22-25