Hills F, et al. – This study aimed is to figure out whether the mode of delivery for singleton extreme preterm breech fetuses is related to a difference in perinatal mortality, neonatal and maternal morbidity. The outcome suggests the caesarean section for singleton extreme preterm breech delivery is related to decreased perinatal mortality, improved neonatal condition at delivery, and increased short–term maternal morbidity.

Methods

• For this research, they designed a retrospective cohort study.
• This research was the study of breech deliveries from 23 + 0 to 27 + 6 weeks gestation (extreme preterm) between 2005 and 2014.
• This study was conducted at a tertiary obstetric facility.

Results

• In this study, they found total 150 deliveries met the selection criteria.
• Perinatal mortality was decreased in the caesarean section group (20% vs 55.5% P < 0.001).
• Apgar scores ≥ 7 (P = 0.008) and cord pH ≥ 7.1 (P = 0.025) were more likely for neonates delivered by caesarean section, with lower rates of birth trauma (P = 0.003).
• Caesarean section was related to higher nursery admission rates (P < 0.001), longer intensive care nursery admission (P = 0.006), continuous positive airway pressure times (P = 0.008) and increased utilization of surfactant (P < 0.001).
• Maternal morbidity was increased with caesarean section including longer hospital stay (P < 0.001), higher postpartum haemorrhage (P < 0.001) and wound infection rates (P = 0.034).