Title: Reproductive outcomes in women after Caesarean section for breech presentation: The experience of a regional Australian centre
S. Craig¹, S. Ooi^2
1 Albury-Wodonga Health, Wodonga, Australia
² Liverpool Hospital, Sydney, Australia

Aims: To retrospectively identify all women having a Caesarean section (CS) for a breech presentation and assess mode of delivery and maternal recollections of delivery options in the next pregnancy with a cephalic presentation.

Methods: This study identified every woman who had a CS for a breech presentation after 34 weeks, between 1998 and 2012, and then had a subsequent pregnancy by 2014. A questionnaire was sent to each woman inquiring about the deliveries, recollections of delivery options given, and maternal desires for mode of delivery after the index pregnancy.

Results: A total of 427 women had a CS for a breech, and of these 183 had further pregnancies with a cephalic presentation at term, thus meting our study criteria. 112 (61%) were delivered by ERCS while 71 (39%) attempted a VBAC.  The VBAC success rate was 87% overall. There was no difference in birth weight between the ERCS and VBAC groups. 38% of women wanted a VBAC but were delivered by ERCS.  58% of women who were delivered by ERCS believed that this was a safer option than VBAC.

Conclusion: Women who have had one CS for a breech are often excellent VBAC candidates. Many women prefer delivery by ERCS due to concerns over safety, whilst others interested in VBAC were not offered it, perhaps highlighting a need for improvement in the delivery planning and counselling process.

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