Breech Delivery in Ahmadu Bello University Teaching Hospital, Zaria: A Six-year Retrospective Review.

Abstract

Background: Breech delivery is associated with maternal and perinatal morbidity and mortality which may be caused by preterm delivery, congenital abnormalities, and birth asphyxia. The other factors which may influence perinatal outcome include quality of antenatal care, route of delivery and the skill of the accoucheur.

Aim: To determine the prevalence, risk factors for breech presentation, and outcome of breech deliveries.

Methodology: This was a cross-sectional retrospective study carried out in our hospital from 1^st January 2014- 31st December 2019. The case folders of women who had breech deliveries during the period of review were retrieved. Information on reproductive profile, maternal and perinatal outcomes was extracted and analyzed. The data obtained were analyzed using the statistical package for social sciences (SPSS) statistical software version 23. The chi-square test was used to test for associations and P <0.05 was set as the level of significance.

Results: The prevalence rate for breech delivery was 11.9%. The commonest identified risk factor was multiple gestation, and no risk factor was identified in nearly half of the cases (47.9%). Stillbirth occurred in 16.3%. Sex, birth weight, and route of delivery were associated with stillbirth (p<0.05). Low birth weight and male sex doubled the odds of being stillbirth and vaginal delivery quadrupled the odds (OR=2.02, CI 1.00-4.04; OR=2.02, CI 2.02-4.00 and OR=4.67, CI 2.26-9.64 respectively). Babies delivered vaginally were more likely to be asphyxiated (OR=1.5, CI 0.81-2.77).

Conclusion: The prevalence of breech delivery was high with an associated increased risk of birth asphyxia in babies delivered via the vaginal route.