Medico-legal issues in a breech delivery

Abstract

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Introduction: A breech delivery is the birth of a baby from a breech presentation, in which the baby exits with the buttocks or feet first. When planned vaginal delivery is compared with planned cesarean delivery, the evidence unequivocally shows the relatively greater safety of planned cesarean delivery for breech presentation at term gestation. Case report : A 34 year old P4C2 full term mother, who had normal past vaginal deliveries, had gestational DM in her second trimester, was found to be having breech presentation well ahead of the EDD. She started dribbling at home and she was admitted to a District Hospital and was transferred to a Base Hospital for specialized management. Normal vaginal delivery was failed and forceps delivery was done. A baby girl was bom but the condition deteriorated rapidly. She became pale and floppy and was admitted to the neonatal unit. Despite resuscitation efforts the baby died 1 V2 hours after birth. Autopsy revealed a contusion under the scalp, a subdural haemorrhage (SDH) at the base and a diffuse subarachnoid haemorrhage (SAH). COD was SDH and SAH due to assisted breech delivery. Mother expressed her dissatisfaction about the medical management during labour. Conclusions : If breech delivery is done vaginally, it should be planned properly. Otherwise, a planned LSCS should have been arranged.