Sätesförlossningar : Handläggning och utfall hos mödrar och barn vid vaginal förlossning och kejsarsnitt

Sammanfattning: Background: The incidence of caesarean section for breech presentation has reached approximately 90 % in Sweden. In many of these cases, by means of specific selection criteria, it would be as safe to plan for vaginal breech delivery.   Aim: The objective of this study was to investigate differences in management and to compare maternal and fetal outcomes according to delivery mode of breech presentation; vaginal vs. caesarian section. The study included breech presentation in full term singleton pregnancies at the UppsalaUniversityHospital, Uppsala, Sweden (UAS).   Method: The study was based on medical record data with a retrospective, descriptive, comparative design with quantitative approach. The method for data collection was a manual review of patient records using a structured questionnaire.   Results: Of the women with children in breech presentation during the period studied, 11 % gave birth vaginally. Mother's wish was the most common cause of caesarean section. The group with caesarean section included more first-time mothers, longer length of stay at the hospital, increased bleeding and need for pain medication, separation from the child, later lactation and earlier introduction of formula. Vaginally delivered mothers had increased incidence of straight urine catheterization postpartum and of infants with lower Apgar scores.   Conclusion: This study does not support the suggestion that it would be safer to give birth by caesarean section for breech presentation in cases where the woman at full term meets strict selection criteria. Instead of applying medical criteria, the decision regarding mode of delivery was more often left up to the mother.