Unexplained Breech presentation due to cornual location of placenta in singleton pregnancies at Ayub Teaching Hospital, Abbottabad

Abstract

Introduction: Breech presentation of the fetus is a significant risk factor for maternal and perinatal morbidity and mortality. Its well-known causes are Polyhydramnios, Oligohydramnios, Hydrocephalus, Uterine anomalies, Pelvic tumors, Placenta Previa, and placental location, particularly Cornual Location.

Objective: The present study was undertaken to evaluate Cornual Location of placenta as a risk factor for breech presentation at Ayub Teaching Hospital, Abbottabad.

Materials & Methods: A case control study was conducted at Department of Obstetrics and Gynecology Unit A of Ayub Medical College Abbottabad from May 01, 2016 to April 30, 2017 on 100 cases of singleton pregnancies from 28 weeks onwards (booked and non-booked), divided into 50 cases of cephalic presentation (controls) and 50 cases of breech presentation (cases) matched for age and parity. Convenience sampling was done for both groups. In all subjects a relevant obstetric history was taken, clinical and obstetric examinations performed and ultrasound localization of the placenta done. Data were recorded on pre designed Performa; the main outcome measure was the frequency of Cornual Location in cephalic and breech pregnancies. Data were analyzed by SPSS 10.0 for descriptive statistics. Correlation was performed as indicated. The Chi Square and Student’s T Tests were used as indicated for qualitative and quantitative variables, respectively. A p≤ 0.05 was considered significant. The Odds Ratio (O.R.) was calculated using 2 x 2 tables.

Results: In 37(74%) patients with breech presentation the placenta was located in the Cornual end of the uterus as compared to 17(34%) in the cephalic presentation group; placental location was fundal in 13(26%) patients in cases group compared to 33(66%) in the controls. These differences were statistically significant with p<0.001. The Odds Ratio for Cornual Location as a risk factor for breech presentation was calculated as 5.5.

Conclusion: Though Cornual Location is a benign condition, it is a risk factor for breech presentation in singleton pregnancies