[Obstetrical prognosis of breech presentations with premature rupture of membranes at term]

Abstract

Objectives: Breech delivery is still a controversial situation in literature. Added complexity exists when breech presentations are associated with premature rupture of membranes (PROM) as such cases are conventionally excluded in studies dealing with PROM and are often indications for elective caesarean section. Thus, the objective of this study was to evaluate the obstetrical prognosis of breech presentations after PROM at term.

Materials and methods: We conducted a retrospective observational study at the Besançon University Medical Centre, between 1(st) January 2008 and 31(th) December 2012. Two groups of patients with breech presentations at term were constituted according to the existence or not of a PROM. The primary endpoint was the delivery mode: caesarean section or vaginal. Other endpoints were maternal characteristics, type of onset of labour and neonatal criterias.

Results: Two hundred and nine patients were included. In the control group, 67.9 % of vaginal deliveries occurred versus 60 % in the group with PROM (P=0.25). No difference was found on neonatal criterias such as pH, lactate and the Apgar score at 5 minutes.

Conclusion: PROM at term in breech presentation doesn't seem to change the obstetrical prognosis and should therefore not be a systematic indication for elective caesarean section.

Keywords: Accouchement; Breech presentation; Delivery; Neonatal condition; Premature rupture of membranes at term; Présentation podalique; Rupture prématurée des membranes à terme; Siège; État néonatal.