DefinePK

Abstract

Background & Objectives: Breech presentation occurs when the fetal buttocks or feet are the presenting parts during labor. It can occur as frank (hips flexed, knees extended), complete breech (hips and knees flexed), or incomplete (not fully flexed hip; one-sided or both-sided). Most of the breech fetuses are frank breech. The increased incidence of breech presentations is associated with lower gestational ages, from 3% to 4% at term, to 28% at 25 28 weeks of gestation. This study aimed to determine the incidence rate of breech deliveries in Duhok Obstetrics and Gynecology Teaching Hospital and to identify the risk factors associated with breech presentation. Methodology: This prospective observational (cross-sectional) study was conducted over 12 months (January 01,2023, to January 01, 2024) at Duhok Obstetrics and Gynecology Teaching Hospital. The study included 452 breech cases and 452 cephalic presentations among 15,446 deliveries presented to the hospital. Women with a gestational age ≥32 weeks were included. Demographic, clinical, and obstetric characteristics, including risk factors, were collected through physical examination, ultrasound, and a structured questionnaire. Comparative analyses between the breech and cephalic groups were performed using Chi-square and t-tests, with P < 0.05 considered statistically significant.
Results: The participants in the present study mostly belonged to the 16–30-year age group. The incidence of breech deliveries was 2.93% (452/15,446). Breech presentation was significantly associated with prematurity (11.28%), premature rupture of membranes (PROM) (10.18%), and multiple pregnancies (5.97%). Less frequent risk factors included smoking 6 (1.33%), fibroids 3 (0.66%), intrauterine growth restriction (IUGR) 3 (0.66%), and preterm premature rupture of membranes (PPROM) 3 (0.66%).
Conclusion: Breech deliveries accounted for 2.93% of the total delivery cases and were significantly correlated with prematurity, PROM, and multiple pregnancies. Effective antenatal care and timely obstetric management are imperative for optimizing outcomes in patients with breech presentations.
Abbreviations: ANC: antenatal care, C/S: cesarean section, IUGR: intrauterine growth restriction, LMP: last menstrual period, PPROM: preterm premature rupture of membranes, PROM: premature rupture of membranes, VD: vaginal delivery.
Keywords: Antenatal care; Breech presentation; Gestational age; IUGR; Incidence rate; Multiple pregnancies; Prematurity; PROM; PPROM
Citation: Ibrahim BK, Ahmed AA. Incidence rate and associated risk factors of breech deliveries in Duhok Obstetrics & Gynecology Teaching Hospital. Anaesth. pain intensive care 2025;29(7):727-733.
DOI: 10.35975/apic.v29i7.2959
Received: July 15, 2025; Revised: August 06, 2025; Accepted: August 10, 2025