Induced labour at term and breech presentation: Experience of a level IIB French maternity

Abstract

Data from the literature on induction of labour in breech presentation are rare and no conclusions can be drawn for this procedure.

Objectives: To evaluate obstetrical and neonatal prognosis following induced labour in breech deliveries at term (37 to 42 weeks of gestation).

Methods: We conducted a single-centre retrospective case-control study in a level IIB maternity unit from 1st January 2012 to 31st December 2015. The inclusion criteria were a singleton pregnancy and a breech presentation.

Results: A total of 235 patients were included, 178 in the spontaneous labour group (group A), 57 in the induced labour group (whatever the procedure used: oxytocin or prostaglandin) (group B). There was no significant difference concerning the vaginal delivery rate between group A and group B (88.2% versus 91.2%). Both groups were also similar for transfers to neonatal units (10.7% versus 15.8%), pH<7.0 (1.1% versus 1.8%) and 5-minute Apgar<4 (1.1% versus 1.7%). There were no neonatal deaths or transfers to neonatal intensive care units.

Conclusion: Induced labour in breech presentation is feasible with a vaginal delivery rate similar to that in spontaneous labour and the same neonatal outcomes. This therapeutic option must be considered in trained obstetrical teams when vaginal delivery in breech presentations is not contraindicated.

Keywords: Breech presentation; Caesarean; Cervix maturation; Induction of labour; Perinatal morbidity.