A recent study published in August 2012 by the American Journal of Obstetrics & Gynecology (AJOG) finds that C-section is the safest method of delivery for preterm babies in the breech position. The research indicates that infants less than 32 weeks gestation had a significantly lower mortality rate when delivered by a planned C-section vs. vaginal delivery.
AJOG Investigates Delivery Methods for Preterm Breech Births
The study considered more than 228,000 deliveries in 2002 through 2008 from 12 clinical centers and 19 hospitals and (after exclusions) included more than 4,350 premature deliveries.
Specifically, the research found that vaginal deliveries were attempted in 31.7% of the deliveries of babies in the breech position at 24 to 27 6/7 weeks gestation. Of these vaginal attempts, only 27.6% were successful and neonatal mortality was 25.2% (vs. 13.2% for C-section deliveries). At 28 to 31 6/7 weeks, there were 30.5% attempted vaginal deliveries of breech infants. Only 17.2% were successful and neonatal mortality was 6.0% (vs. 1.5% for C-section deliveries).
There is always a certain amount of risk associated with the attempted vaginal delivery of breech infants. If the baby is preterm, the risk is compounded. This study shows that infant deaths were greater in vaginal deliveries than in C-section deliveries for this high-risk group of infants. Obstetricians are bound by standards of care to deliver a baby in the safest manner possible. It is clear from this study that in the case of premature breech infants, the safest method is C-section.
Furthermore, this study considered only infant deaths. It did not consider infants that were seriously and permanently disabled due to birth injuries. Umbilical cord prolapse, nerve damage/Erb’s palsy and other traumatic injuries are well-documented causes of cerebral palsy and other permanent disabilities from the attempted vaginal delivery of breech babies.
Video: Breech Presentation
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Given high infant mortality rates and the potential for permanent birth injuries, it is puzzling that physicians today would even opt for vaginal delivery of preterm breech infants. If your child was diagnosed with permanent physical or mental disabilities as a result of breech and/or premature birth, you may have grounds for a medical malpractice suit.
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