Neonatal outcome of breech babies in Toa Payoh Hospital 1984-1989
Ho, N.K.
Singapore Medical Journal 33(4): 333-336
1992
ISSN/ISBN: 0037-5675 PMID: 1411659 Document Number: 403162
From 1984 to 1989, a total of 575 breech babies were born out of 21,243 livebirths (2.71%) in the Toa Payoh Hospital, Singapore. There were 259 male and 316 female infants, a sex ratio of 1 to 1.22. There were also no marked differences in the frequency of breech birth among the different racial groups. Many breech babies (385 or 67%) were delivered by Caesarean section and the mortality and morbidity were noted to be low in this series. We had 7 deaths, all weighing below 2000gm and only one, a premature infant, was delivered by Caesarean section. The majority of the infants had no evidence of asphyxia at birth (87.7%); and for those who had asphyxia (13.3%), two-thirds were delivered vaginally and one-third, by Caesarean section. The malformation rate in breech babies was twice that of non-breech babies (7.13% vs 3.08%, p = 10(-6)). Most birth defects were minor in nature. Only 10% of birth defects were major malformations. 5.9% (34) of all the breech babies were low birth weight (LBW), 1/3 (11) of them were delivered by Caesarean section with one death. However, there was no increasing trend of Caesarean section for LBW breech infants in the Hospital. Over the past 6 years, out of the 23 LBW breech babies delivered vaginally, 6 deaths were noted. There were 13 breech stillbirths, the majority of which were macerated (7/13 or 53.8%). The stillbirth rate (SBR) for breech was 22 per 1000 breech livebirths and stillbirths. The SBR for babies born normally was 5.15. The corrected breech SBR was 18.7 after exclusion of lethal malformations.