PERINATAL OUTCOME AND ASSOCIATED FACTORS AMONG MOTHERS WHO DELIVERED SINGLETON BREECH AT HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, HARAR, EASTERN ETHIOPIA

Abstract

Breech deliveries have always been major issues in obstetrics because of the very high perinatal mortality and morbidity. These are due to combination of trauma, birth asphyxia, prematurity and malformation. Objectives: To assess perinatal outcome and associated factors among breech deliveries in HFSUH, Harar, Eastern Ethiopia from July 1 to July 30, 2021 Methods: Institution based cross-sectional retrospective study was conducted among 623 selected cards by simple random sampling technique using computer generated random number. Data were collected by reviewing records of all pregnant women with a clinical diagnosis of breech presentation and gave birth in HFSUH from January 1, 2018 to December 31, 2020. The collected data have been checked for its completeness, and was analyzed by using SPSS for windows version 20. Multivariable logistic regression with adjusted odd ratio and 95% confidence interval was used to identify predictors of a single tone breech perinatal outcome. Statistical significance was declared at p-value less than 0.05. Result: Out of 636 calculated sample size, a total of 623 singleton breech deliveries were recorded in the past 2 years were included in this study which yields a response rate of 98%. The reported perinatal outcomes among single tone breech deliveries were 480(77%) livebirth and 143(23%) dead/stillbirth, which indicates the perinatal mortality rates to be 230 per 1000 singleton breech presentations. The possible causes of deaths among dead fetus were entrapment of head 83(58%), prolapsed cord 31(21.7%), birth asphyxia 12(8.4%) and intrauterine death with unknown cause 15(10.5%). Mothers who have ANC follow up were 2.2 times less likely to have fetal loss than those without mothers who had no ANC follow up. Mode of delivery has significant statistical association with perinatal loss. Conclusion and Recommendation: In this study, it can be concluded that the perinatal mortality rate of singleton breech deliveries was high, Entrapment of head, birth cord prolapse and asphyxia were the most common causes of perinatal mortality