Perinatal outcomes of intended vaginal breech births with epidural versus non-epidural analgesia

Objective We conducted this prospective trial to investigate the role of an epidural analgesia on the success, progress and safety of vaginal breech deliveries at term.

Study Design Between January 2004 and December 2018, we included 1413 patients who were counseled regarding a vaginal term breech delivery of a singleton in our center and met the inclusion criteria. We analyzed neonatal and maternal short-term outcome as well as the mode of delivery and the duration of the birth in our patient collective.

Results When patients decided on an epidural analgesia, spontaneous delivery was significantly less likely in comparison to a cesarean section or vaginal birth with manual assistance. Our data showed a prolongation of the birth duration in nulliparous and in multiparous patients when the women opted for an epidural anesthesia in a subcohort analysis of vaginal deliveries. The rate and severity of maternal birth injuries as well as neonatal morbidity and mortality were unaffected by an epidural analgesia.

Conclusion We conclude that patients with the desire for an epidural anesthesia during a vaginal breech birth should be counseled regarding the clear benefits of this intervention such as pain-free up-right mobilization but also about the demonstrated downside, i.e. the prolongation of the birthing process.

Publication History

Article published online:
07 October 2020