Maternal and perinatal outcomes of breech deliveries at a Nigerian hospital

Breech presentation is the most common malpresentation of pregnancy associated with increased risk of adverse feto-maternal outcome. The best mode of delivery of breech presentation has remained an area of controversy in obstetrics for years. The aim of this study was to determine the distribution, incidence, mode of delivery and outcome of breech deliveries in this centre. This was a descriptive retrospective study of breech deliveries at Federal Medical Centre, Yenagoa over a 3-year period. Data was obtained from the labour ward register, theatre register and the case notes and analyzed.There was a total of 2,263 deliveries during the study period, out of which one hundred and sixty four (164) were breech deliveries. The breech delivery rate for all gestational ages from this study was 7.2%. However the term breech delivery rate was 3.9%. Breech delivery was commoner amongst multiparous (60.4%) than in primiparous (30.8%) women and primigravidae (8.8%). The age of patients ranged from 18 – 46 years. Extended (Frank) breech delivery accounted for 56.6% of cases. There was no maternal mortality but the perinatal mortality rate was 182.3/1000 total births with about 17(58.6%) of these deaths diagnosed as Intrauterine fetal death on admission.  This study has shown that the incidence of breech is slightly lower than in many studies, and breech deliveries were mostly unplanned and more among multiparae.Planned breech deliveries had better neonatal outcomes and babies with birth asphyxia and those stillborn were more in the unplanned and unbooked cases with breech.