COMPARISON BETWEEN NEONATAL OUTCOME OF VAGINAL DELIVERY AND CAESAREAN SECTION FOR BREECH PRESENTATION

Abstract

Background: Breech presentation at term poses a significant obstetric challenge, often associated with increased neonatal morbidity. The mode of delivery in such cases remains a topic of clinical debate, with cesarean section usually preferred to minimize neonatal complications. However, comparative data on neonatal outcomes between vaginal and cesarean deliveries for breech presentations are still evolving, especially in resource-limited settings. Objective: To compare neonatal outcomes, specifically low Apgar scores, between vaginal delivery and cesarean section in term breech presentations. Study Design: Descriptive cross-sectional study. Setting: Conducted at the Department of Obstetrics & Gynecology, Saidu Group of Teaching Hospital, Swat, Pakistan. Duration of Study: 21-07-2024 to 21-01-2025. Methods: A total of 145 women aged 18–40 years with singleton term pregnancies (37–41 weeks) presenting with breech were included. Participants underwent either vaginal delivery or cesarean section. Neonatal outcome was assessed based on the Apgar score at 5 minutes, with a score <7 considered low. Data analysis was conducted using SPSS version 24. Categorical variables were compared using the chi-square test, with a p-value ≤ 0.05 considered statistically significant. Results: Of the 145 participants, 49 (33.8%) underwent vaginal delivery and 96 (66.2%) had cesarean sections. A significantly higher proportion of neonates delivered vaginally had low Apgar scores at 5 minutes (14.3%) compared to those delivered via cesarean section (4.2%) (p = 0.02). Conclusion: Elective cesarean section for term breech presentation is associated with improved neonatal outcomes, as evidenced by a significantly lower incidence of low Apgar scores compared to vaginal delivery. These findings support the consideration of cesarean delivery as a safer option for breech presentations at term.