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Vannerum M, Subtil D, Drumez E, Brochot C, Houfflin-Debarge V, Garabedian C. [Per-partum risk factors of neonatal acidemia in planned vaginal delivery for fetuses in breech presentation]. ACTA ACUST UNITED AC 2018; 47:11-17. [PMID: 30563786 DOI: 10.1016/j.gofs.2018.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Delivery mode of term breech presentation is debated because of higher rate of neonatal acidosis (pH<7.15) in planned vaginal delivery than in planned caesarean section. The objective was to evaluate per-partum risk factors of neonatal acidosis in vaginal delivery for podalic fetuses. METHODS It was a single-centre, case-control retrospective study that included planned vaginal delivery in singleton term breech presentation between 2012 and 2016. The "case" group defined by neonatal pH≤7.10 and the "control" group defined by neonatal pH≥7.20 were matched. The maternal, labor, and neonatal characteristics were noted. RESULTS One hundred and thirty-two patients were included: each of 44 patients in "case" group, has been matched according to breech type (legs position) to 2 patients in the "control" group, so 88. In multivariate analysis, significant risk factors identified were oxytocin use [ORa=5.663 (95% CI=1.844-17.397)], "high risk" fetal heart rate (FHR) abnormalities according to FIGO classification [ORa=10.997 (95% CI=1.864-64.866)] and FHR abnormalities during expulsion, Melchior 2 [ORa=8.088 (95% CI=1.192-54.875)] and Melchior 4 [ORa=12.705 (95% CI=1.157-139.541)]. CONCLUSIONS These risk factors of neonatal acidemia have to be known to improve the labor management in case of breech planned vaginal delivery.
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Affiliation(s)
- M Vannerum
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France.
| | - D Subtil
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
| | - E Drumez
- EA 2694 - santé publique : épidémiologie et qualité des soins, département de biostatistiques, université de Lille, CHU de Lille, 6, rue du Professeur-Laguesse, 59037 Lille, France
| | - C Brochot
- Maternité, centre hospitalier d'Arras, 3, boulevard Georges-Besnier, 62000 Arras, France
| | - V Houfflin-Debarge
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
| | - C Garabedian
- Clinique d'obstétrique, CHU de Lille, avenue Eugène-Avinée, 59000 Lille, France; EA 4489, faculté de médecine Henri-Warembourg, université de Lille, 2, avenue Eugène-Avinée, 59120 Loos, France
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