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FREQUENCY OF PRIMIGRAVIDAS PRESENTING IN LABOUR AT TERM WITH UNDIAGNOSED BREECH AND ITS PERINATAL OUTCOME

Dr. Taila Amber, Dr. Asma Qayyum, Dr. Sadaf Zahra

Objective: To determine the frequency of undiagnosed breech and its perinatal outcome in primigravidas presenting in labour. Setting: Gynecology and obstetrics, Lady Willingdon Hospital, Unit 2, Lahore Study Design: Descriptive case series Duration: Study was completed in 6 months after the approval of synopsis (5th March 2014 till 5th September 2014). Methods: After the approval of the study by the ethical committee of the Lady Willingdon Hospital and informed consent, the cases fulfilling the inclusion criteria was registered. Demographic variables were noted. Whether the breech pregnancy was diagnosed antenatally or undiagnosed was established. Short term neonatal outcomes in terms of Apgar score (at 5 minutes), birth asphyxia, birth injury and admission to neonatal intensive care was be noted. All this information was recorded in a pre-designed performa. Data entry and analysis was done by using SPSS 20. Results: Mean age of the patients was 24.14±2.48 years. There were 195(78%) patients with undiagnosed breech and 55 patients were diagnosed for breech. There were only 10(5.1%) neonates with poor APGAR score. There was only 1(0.5%) neonate who was admitted to NICU.There is no significant association between Poor APGAR score and admission to NICU with age group of the patients. There were 10 neonates who had poor APGAR score at 5 minutes, mothers of all these neonates were presented as undiagnosed breech.No significant association was present between poor APGAR score and undiagnosed breech presentation. No significant association between undiagnosed breech and neonate admission to NICU. Conclusion: As per findings of this study high frequency of undiagnosed breech before admission was seen in primigravid as before admission. i.e.195/250 (78%). However prenatal outcome showed that poor APGAR score at 5 minute was seen in 10(5.1%) neonates and only 1(0.5%) neonate was admitted to NICU. These result can help us to diagnose breech before admission in primigravidas before presenting for their delivery so that timely and accurate decision can be made regarding mode of delivery as well as better perinatal outcome. Key Words: Undiagnosed breech, Perinatal outcome, Primigravidas, Labour