Changing patterns in the management and outcome of breech presentation over a 7-year period. Review from a referral hospital in Saudi Arabia

A retrospective study that was conducted on 755 singleton breech deliveries over a 7-year period between January 1994 and December 2000 at a referral hospital in Saudi Arabia showed that it represented 3.35% of all deliveries. There was a statistically significant trend in caesarean section (P= 0.001) accompanied by a modest linear trend in perinatal mortality (P = 0.049). There were no statistically significant differences in the mean age, parity and birth weight when the women delivered during each year were compared (P > 0.05), but there were statistically significant differences in the gestation at delivery (P < 0.05). Furthermore, statistically significant differences were found in the trends of the preterm breech deliveries and booking status over the period of study (P > 0.05). However, there was no statistically significant linear trend in the birth trauma (P > 0.05). Nineteen cases of the fetal birth trauma (67.8%) were associated with vaginal breech delivery while nine cases (32.2%) were reported from caesarean section. This was statistically significant (P = 0.00074). The role of selective external cephalic version as a way of reducing the caesarean section rate and also trauma during vaginal breech delivery at term in our community is discussed.