American Journal of Obstetrics & Gynecology
Volume 198, Issue 3 , Pages 289.e1-289.e6, March 2008

Early preterm breech delivery: is a policy of planned vaginal delivery associated with increased risk of neonatal death?

  • Gilles Kayem, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, School of Medicine Paris XII, Créteil, Paris, France
    • Corresponding Author InformationReprints: Gilles Kayem, MD PhD, University Paris XII, Centre Hospitalier Intercommunal de Créteil, Department of Obstetrics and Gynaecology, 40 avenue de Verdun, 94010 Créteil cedex.
    • ,
  • Raphaël Baumann, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, School of Medicine Paris XII, Créteil, Paris, France
    • ,
  • François Goffinet, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, Maternity Port-Royal, Cochin-Saint Vincent-de-Paul Hospital AP-HP, School of Medicine Paris V, Paris, France
    • ,
  • Sawsan El Abiad, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, School of Medicine Paris XII, Créteil, Paris, France
    • ,
  • Yves Ville, MD

      Affiliations

    • Department of Obstetrics and Gynecology, School of Medicine Paris Ile de France Ouest, Centre Hospitalier Intercommunal Poissy-Saint-Germain en Laye, Poissy, France.
    • ,
  • Dominique Cabrol, MD, PhD

      Affiliations

    • Department of Obstetrics and Gynecology, Maternity Port-Royal, Cochin-Saint Vincent-de-Paul Hospital AP-HP, School of Medicine Paris V, Paris, France
    • ,
  • Bassam Haddad, MD

      Affiliations

    • Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal de Créteil, School of Medicine Paris XII, Créteil, Paris, France

Received 1 June 2007; accepted 11 October 2007. published online 13 February 2008.

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.

Key words: breech, head entrapment, neonatal death, preterm

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 Cite this article as: Kayem G, Baumann R, Goffinet F, et al. Early preterm breech delivery: is a policy of planned vaginal delivery associated with increased risk of neonatal death? Am J Obstet Gynecol 2008;198:289.e1-289.e6.

PII: S0002-9378(07)02016-9

doi:10.1016/j.ajog.2007.10.794

American Journal of Obstetrics & Gynecology
Volume 198, Issue 3 , Pages 289.e1-289.e6, March 2008

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