http://dx.doi.org/10.5455/2320-1770.ijrcog20140921 Volume 3 · Issue 3 Page 562 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Gutgutia I et al. Int J Reprod Contracept Obstet Gynecol. 2014 Sep;3(3):562-565 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Vaginal delivery for breech presentation should be an option: experience in a tertiary care hospital Isha Gutgutia 1 , Monika Gupta 2 *, Banashree Das 3 INTRODUCTION Incidence of breech presentation is 3% to 4% in singleton pregnancies at term. Mode of delivery in breech presentation has long been a topic of debate. Many studies including the Term Breech Trial (TBT) 1 have concluded that vaginal breech delivery at term is associated with increased perinatal morbidity and mortality. 1-3 Vaginal breech delivery has also been reported with an increased risk of fetal trauma. 1-3 The TBT by Hannah et al. 1 published in 2000, made many obstetricians believe that neonatal risks associated with term breech births are much higher among planned vaginal deliveries and implied that Caesarean Section (CS) should be systematically planned for all such women. These consequently led American College of Obstetricians & Gynaecologists (ACOG) to officially recommend in 2001 that CS should be performed in the case of a singleton breech at term. This recommendation led to a radical change in practice, with a CS rate as high as 86.9% in the United States in 2002 for breech presentations at term. 4 On the other hand, CS has risks; it is associated with more significant short- and long-term maternal morbidity, as well as a higher rate of complications during subsequent pregnancies than vaginal delivery. 2 Contrary to prevailing practice French obstetricians continued to perform vaginal breech deliveries at term, with reassuring results. 5,6 Various retrospective observational studies done in Europe and published in the last decade show planned vaginal 1 Department of Obstetrics & Gynaecology, Christian Medical College, Vellore, Tamil Nadu, India 2 Assistant Professor, Hamdard Institute of Medical Sciences and Research & HAHC Hospital, Jamia Handard, New Delhi, India 3 Consultant, Professor & Unit head, Vardhman Mahavir Medical College & Safdarjang Hospital, New Delhi, India Received: 8 June 2014 Accepted: 23 June 2014 *Correspondence: Dr. Monika Gupta, E-mail: drmonikagupta@hotmail.com © 2014 Gutgutia I et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: The purpose of this prospective study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Methods: 290 women with singleton breech presentation at term in labor were counseled about the risks and benefits of both the modes of delivery. Neonatal and maternal outcome were recorded and statistically analyzed. Results: APGAR at 5 min and NICU admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusions: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Keywords: Vaginal delivery, Caesarian section, Breech presentation DOI: 10.5455/2320-1770.ijrcog20140921