Prevalence, Maternal and Perinatal Prognosis of Breech Delivery Compared to That of the Vertex in 242 Cases for 484 Controls at Ségou Hospital in Malti

Introduction: Breech birth has always been a subject of great interest because of its risks of perinatal morbidity and mortality. Aim: The aim of our study was to compare the maternal and perinatal prognosis of breech delivery with that of vertex delivery. Patients and Method: This was a retrospective case-control analytical study carried out in the obstetrics and gynaecology department of Ségou hospital over a 2-year period from 1 January 2020 to 31 December 2021, involving 242 breech deliveries compared with 484 top deliveries with a live single foetus without foetal malformation of gestational age ≥ 35 SA. The statistical tests used were: chi2 (p < 0.05), Odds ratio (OR) and its 95% confidence interval (CI). Results: The frequency of breech delivery was 3.3%, with a predominance of caesarean section for breech presentation (64.88%) compared with 32.85% for vertex (P: 0.00; CI: (0.191 - 0.367). The perinatal prognosis of fetuses with breech presentations was marked by a higher rate of neonatal asphyxia (Apgar score < 7) (2.95%) than that of fetuses with apex presentations (0.41%) at both the 1st and 5th minute P: 0.00; CI: (0.00 - 0.004). The risk of stillbirth was 5 times higher for breech deliveries (2.07%) than for vertex deliveries (0%) (P: 0.00; CI: (0.00 - 0.004). Maternal complications were more frequent in breech deliveries (2.48% post-partum haemorrhage, 1.24% perineal tear and 0.83% uterine rupture) compared with 1.65% post-partum haemorrhage, 1.03% perineal tear and 0.62% uterine rupture respectively in vertex deliveries. There were no deaths in either group. Conclusion: Breech birth is relatively rare in our department. It carries a higher risk of maternal morbidity and neonatal morbidity than breech delivery. However, the vital prognosis for the mother was identical in both groups.