Neonatal outcomes of breech presentation delivered by cesarean section: A retrospective study from a tertiary hospital in Sudan

Breech presentation remains a major obstetric challenge particularly in low resource settings where skilled intrapartum management is not widely available.Cesarean section is a preferred modality of delivery to reduce neonatal morbidity.In this study, neonatal outcomes were assessed for all breech presentations performed by cesarean section at a tertiary hospital in Sudan, with the key factors of gestational age and parity being assessed.A retrospective cross-sectional study was performed at Bashair Hospital, reporting 54 breech presentations by cesarean section within a 1-year period.We conducted analyses of maternal characteristics, neonatal outcomes, and association with gestational age and parity.Important outcomes were birth weight, Apgar scores, NICU admission and immediate neonatal complications.Most mothers were aged 20-34 years and were multigravida.Three quarters of cases were term pregnancies.Nearly half of the neonates were > 3000 g, while one fifth were low birth weight.Mean Apgar score improved from 7.8 at 1 minute to 9.1 at 5 minutes, and only 2 neonates had a score less than 7 at 5 minutes.Admission to NICU was 16.7% based mainly on respiratory distress.Preterm breech neonates had worse outcomes, including rates of low Apgar scores, NICU admission and low birth weight.No significant associations between parity and neonatal outcomes were found.The Cesarean delivery for breech presentation group yielded overall positive neonatal outcomes, most significantly amongst term infants.Prematurity was the best predictor of neonatal morbidity, suggesting the importance of greater antenatal surveillance and preparedness for preterm births due to breech births.For neonatal outcomes, parity had little impact.Improvements in the quality of clinical protocol and the early detection of high-risk pregnancies may also enhance the outcome in comparable settings.