Head entrapment and neonatal outcome by mode of delivery in breech deliveries from twenty-four to twenty-seven weeks of gestation.

Objectives: Our purpose was to determine whether there are differences in the incidence of head entrapment and adverse neonatal outcome by mode of delivery in breech deliveries from 24 to 27 weeks of gestation.

Study Design: Charts of 132 viable consecutive singleton breech deliveries from 24 to 27 weeks' gestation were reviewed. Statistical methods used included chi 2, logistic regression, and analysis of variance.

Results: Head entrapment occurred in four of 43 (9.3%) vaginally delivered neonates and five of 89 (5.6%) neonates delivered by cesarean section (p = 0.17). The only identifiable risk factor for head entrapment was the birth weight category 1000 to 1249 gm (odds ratio 6.4, 95% confidence interval 1.6 to 26.1). There were no statistically significant associations between head entrapment and adverse neonatal outcomes.

Conclusions: There did not appear to be a difference in the incidence of head entrapment by mode of delivery for breech infants at 24 to 27 weeks' gestation, nor did there appear to be a difference in adverse neonatal outcomes after entrapment. However, this latter conclusion has limited power because of the small number of head entrapment cases.