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  • Title: Early preterm breech delivery: is a policy of planned vaginal delivery associated with increased risk of neonatal death?
    Author: Kayem G, Baumann R, Goffinet F, El Abiad S, Ville Y, Cabrol D, Haddad B.
    Journal: Am J Obstet Gynecol; 2008 Mar; 198(3):289.e1-6. PubMed ID: 18241827.
    Abstract:
    OBJECTIVE: The purpose of this study was to compare neonatal death rates in preterm singleton breech deliveries from 26 weeks to 29 weeks 6 days of gestation in centers with either a policy of planned vaginal delivery (PVD) or planned cesarean delivery (PCD). STUDY DESIGN: Women with preterm singleton breech deliveries were identified from the databases of 3 perinatal centers and classified as PVD or PCD according to the center's management policy. RESULTS: The study included 84 women in the PVD group and 85 women in the PCD group. Incidence of neonatal death was similar in both (10.7% vs 7.1%; P = .40). Head entrapment (adjusted odds ratio, 7.2; 95% CI, 1.7-29.8), preterm premature rupture of membranes at <24 weeks of gestation (adjusted odds ratio, 13.3; 95% CI, 2.8-63.0), and gestational age between 26 weeks and 27 weeks 6 days of gestation (adjusted odds ratio, 4.7; 95% CI, 1.2-18.5) were associated independently with neonatal death. CONCLUSION: Risk of neonatal death was not associated with any particular policy of mode of delivery.
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