Perinatal outcome of vaginal breech delivery in Orotta National Referral Teaching Hospital, Eritrea, 2024; a case control study

Abstract

Introduction Delivery of fetus in breech presentation is a controversial topic in obstetrics and it had been the subject of debate since 1980s. As experts with abilities and know-how to perform vaginal breech delivery have decreased, and medico legal concerns increased, some physicians endorse cesarean section for breech presentation at term. The aim of this study was to identify the perinatal outcome in vaginal breech deliveries. Methodology This study was a retrospective case control study of mothers delivered vaginally between January 1, 2019 and December 31, 2023 in Orotta National Referral Teaching Hospital. Mothers who gave vaginal breech delivery (VBD) were enrolled as cases and two successive vertex vaginal deliveries (VVD) as controls. Results A total of 1919 patient records were analyzed, of which 641(33.6%) were cases and 1278 (66.4%) controls. The mean age and parity of the mothers was 28.98 (SD = 5.56) and 2.18 (SD = 1.96) respectively. History of previous stillbirth was documented in 0.4% and multiple pregnancies found in 10.2% of the study participants. The prevalence of stillbirth was 5% (1% in controls and 4% in cases). In multivariate analysis address from other zobas (AOR: 3.63, 95% CI: 2.17–6.09, p < 0.011), high gravidity (AOR: 1.62, 95% CI: 1.18–2.22, p < 0.001), low birth weight (AOR: 2.03, 95% CI: 1.42–2.90, p < 0.001), and multiple fetus (AOR: 4.83, 95% CI: 3.28–7.11, p < 0.001, were associated with risk of having vaginal breech delivery. Primiparity (AOR: 0.25, 95% CI: 0.18–0.36 p < 0.001) and birth weight >3.4 kg (AOR: 0.61, 95% CI: 0.47–0.79, p < 0.001) were protective against having vaginal breech delivery. Vaginal breech deliveries was found to be associated low first minute Apgar (AOR: 14.95, 95% CI: 9.36–23.26, p < 0.001). Conclusion Vaginal breech delivery was associated with low first minute Apgar. Address from others zobas, high gravidity, low birth weight, and multiple fetuses increases the risk of having Breech presentation, Vaginal breech delivery, Perinatal morbidity, Nulliparous vaginal breech delivery while primiparity and increasing birth weight were protective.