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Claire G, Diane K, Olivier S. Neonatal morbidity and mortality for preterm in breech presentation regarding the onset mode of labor. Arch Gynecol Obstet 2023; 307:729-738. [PMID: 35474495 DOI: 10.1007/s00404-022-06526-z] [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: 01/11/2022] [Accepted: 03/11/2022] [Indexed: 11/02/2022]
Abstract
PURPOSE To assess severe neonatal morbidity and mortality in induced labor in preterm breech deliveries, compared to spontaneous labor. METHODS This is a retrospective study conducted in a tertiary university center in France. Women with single live breech pregnancy between 28 + 0 and 36 + 6 weeks gestation were included. We excluded situations with medical contraindication to vaginal delivery and fetal malformations. We compared women with an unfavorable cervix, who had an indication for deliver and could receive cervical ripening to induce labor, to women in spontaneous labor. The primary outcome was a composite criterion of severe neonatal morbidity and mortality including perinatal death, traumatic event during delivery, Apgar score at 5-min < 4, moderate or severe encephalopathy, seizures within the first 24 h, Intra-Ventricular Hemorrhage grade 3 or 4, necrotizing enterocolitis grade 2 or 3. RESULTS We included 212 patients: 64 in the induced labor group and 136 in the spontaneous labor group. In the induced labor group, 45.3% of patients delivered vaginally, and 86% in spontaneous labor group. The neonatal morbidity and mortality rate were similar in both groups: 4.7% in the induced labor group, and 5.2% in the spontaneous labor group, p = 0.889, aOR = 1.5 (0.28-8.28). CONCLUSION Nearly half of the patient who received induction of labor delivered vaginally. The onset mode of labor does not appear to have an effect on severe neonatal morbidity and mortality in preterm breech fetuses. Induction of labor could be an option for patients in this setting.
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Affiliation(s)
- Guerini Claire
- Service de Gynécologie Obstétrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
| | - Korb Diane
- Service de Gynécologie Obstétrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France. .,Centre for Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRA, Université de Paris, Paris, France.
| | - Sibony Olivier
- Service de Gynécologie Obstétrique, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
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Breech presentation induction compared to cephalic presentation: Effectiveness and characteristics. Eur J Obstet Gynecol Reprod Biol 2023; 282:155-160. [PMID: 36738640 DOI: 10.1016/j.ejogrb.2023.01.030] [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: 09/16/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023]
Abstract
INTRODUCTION The objective of our study was to compare the effectiveness of induction in cephalic presentations to that of breech presentations as well as the characteristics of the latter and the maternal-fetal morbidity and mortality. MATERIAL AND METHODS This was a single-center retrospective study carried out at the Lille University Hospital in the Jeanne de Flandre Maternity Hospital including all patients with a breech fetus for whom an induction was indicated beyond 37 weeks of gestation between January 2014 and December 2020. A matching was performed to include 2 cephalic presentations for one breech presentation. The primary outcome was successful induction defined by two things: passage into the active phase (cervical dilatation > 5 cm) and vaginal delivery. RESULTS 101 inductions of breech presentations were included and matched to 202 cephalic presentations. After adjustment by BISHOP score, there was no significant difference in the caesarean section rate between the two groups (25.7% in cephalic vs 33.7% in breech, OR 0.67 [CI95% 0.38-1.18]) or in the rate of transition to active phase (80.7% in cephalic vs 82.2% in breech, OR 1.26 [CI95% 0.65-2.44]). Post-partum blood loss was not significantly different between the two groups (14.4% in cephalic vs 12.9% in breech, OR 1.22 [CI95% 0.57-2.57]). Moderate neonatal acidosis was more frequent in the breech group (6,4% in cephalic vs 15,8% in breech, OR 3.04 [CI95% 1.38-6.71]). CONCLUSION Induction of breech births beyond 37 weeks of gestation appeared to be as effective as induction of cephalic presentations. There was no difference in the rate of caesarean section and transition to active labor. Maternal morbidity was not increased.
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Nkobetchou M, Korb D, Giral E, Renevier B, Sibony O. Cervical ripening for a singleton fetus in breech prensentation at term: Comparison between mechanical and pharmaceutical methods. J Gynecol Obstet Hum Reprod 2021; 51:102258. [PMID: 34695622 DOI: 10.1016/j.jogoh.2021.102258] [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: 02/28/2021] [Revised: 10/10/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
Although various international professional societies currently recommend trial of vaginal delivery of term fetuses in breech presentation, the question of the method of cervical ripening, when necessary, remains open. OBJECTIVE To compare the effectiveness of two methods of cervical ripening for delivery of a singleton fetus in breech presentation at term: a mechanical method (balloon catheter) and a pharmaceutical method (prostaglandins). STUDY DESIGN This two-center retrospective study reviewed records from 2014 through 2019 in two French maternity units with two different cervical ripening methods for fetuses in breech presentation. The study included all women with cervical ripening for a medical indication with a live singleton fetus in breech presentation ≥ 37 weeks, with an unfavorable cervix. The group treated with a mechanical method was compared with the group receiving a pharmaceutical method. The cesarean delivery rate was the principal outcome, and maternal and neonatal morbidity the secondary outcomes. RESULTS We included 74 women, 19 with mechanical cervical ripening, and 55 with pharmaceutical treatment. The cesarean rate was 57.9% in the balloon catheter group and 40% in the prostaglandin group (P = 0.097) (crude OR =2.06, 95% CI [0.72 - 5.94]; adjusted OR = 2.88, 95% confidence interval [0.52-15.96]), and the postpartum hemorrhage rates 21.1% and 1.8% respectively (P = 0.008). Neonatal morbidity did not differ significantly. CONCLUSION Although the cesarean rate and neonatal morbidity and mortality did not differ significantly between these two methods of cervical ripening, our study lacked power.
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Affiliation(s)
- Maëlys Nkobetchou
- Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, Paris, France.
| | - Diane Korb
- Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, Paris, France; Université de Paris, Centre for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPE, INSERM, INRA, Paris, France
| | - Emilie Giral
- Department of Obstetrics and Gynecology, André Grégoire Hospital, Montreuil, France
| | - Bruno Renevier
- Department of Obstetrics and Gynecology, André Grégoire Hospital, Montreuil, France
| | - Olivier Sibony
- Department of Obstetrics and Gynecology, Robert Debré Hospital, APHP, Paris, France
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Mu XH, Shi HX, An R. Anesthesia efficacy of bupivacaine in pregnant participants with breech presentation receiving external cephalic version: A protocol of systematic review of randomized controlled trials. Medicine (Baltimore) 2020; 99:e20786. [PMID: 32569223 PMCID: PMC7310873 DOI: 10.1097/md.0000000000020786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The objective of this study is to appraise the efficacy and safety of bupivacaine in pregnant participants with breech presentation (BP) receiving external cephalic version (ECV). METHODS The following electronic databases will be searched from the origin to the January 31, 2020: PUBMED, EMBASE, Cochrane Library, CINAHL, ACMD, PsycINFO, Scopus, OpenGrey, and China National Knowledge Infrastructure. No language and publication time limitations will be applied to all of them. Randomized controlled trials comparing bupivacaine to other interventions for pain relief in pregnant participants with BP undergoing ECV will be included in this study. Two authors will employ the selection of searched records, extraction of essential data from included RCTs, and risk of bias assessment for each eligible trail independently and respectively. Any doubts between 2 authors will be figured out by a third author through discussion. The risk of bias assessment will be judged using Cochrane risk of bias tool. The data pooling and analysis will be performed using RevMan 5.3 software. RESULTS This study will summarize the up-to-date high-quality evidence and will synthesis the outcome data from that evidence to explore the efficacy and safety of bupivacaine for pain relief in pregnant participants with BP undergoing ECV. CONCLUSION The findings of this study may present important guidance for patients, clinical practice, as well as health-policy makers regarding the utilization of bupivacaine for pain relief in pregnant participants with BP receiving ECV. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020164409.
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Affiliation(s)
- Xin-hua Mu
- Department of Anaesthesiology, The Affiliated Hospital of Inner Mongolia Medical University
| | - Hai-Xia Shi
- Department of Anaesthesiology, The Affiliated Hospital of Inner Mongolia Medical University
| | - Ran An
- Department of Emergency, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
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Parant O, Bayoumeu F. [Breech Presentation: CNGOF Guidelines for Clinical Practice - Labour and Induction]. ACTA ACUST UNITED AC 2019; 48:136-147. [PMID: 31678504 DOI: 10.1016/j.gofs.2019.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To issue guidelines on management of labour induction and breech vaginal delivery. MATERIALS AND METHODS Bibliographic search restricted to French and English languages using Medline database®, Cochrane Library and international guidelines of medical societies. RESULTS Breech delivery must take place in a maternity ward, in the presence of an obstetrician and gynaecologist and with the immediate availability of an anesthesiologist and a pediatrician during active second stage (Professional consensus). Term breech is not a contraindication to labour induction when the criteria for acceptance of vaginal delivery are met (Grade C). In this case, oxytocin or prostaglandins can be used (Grade C). Epidural analgesia with low concentrations of local anesthetics should be encouraged in case of vaginal delivery attempt (Professional consensus). It is recommended to use continuous monitoring of the CTG (Professional consensus). The use of second-line fetal monitoring is not recommended (Professional consensus). The administration of oxytocin is possible for labour augmentation (Professional consensus). It is better to start the expulsive efforts when the presentation is engaged as low as possible in the pelvic excavation (Professional consensus). Breech presentation is not an indication of episiotomy (Professional consensus). Due to insufficient data, it was not possible to make recommendations on specificities of preterm breech delivery. CONCLUSION In case of planned vaginal delivery, labour induction is possible for term breech fetuses, even with unfarable cervix. Guidelines for labour and vaginal delivery management have a low level of evidence.
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Affiliation(s)
- O Parant
- Équipe SPHERE, Inserm, UMR1027, 31073 Toulouse, France; UMR1027, université de Toulouse III, 31073 Toulouse, France; Pôle de gynécologie-obstétrique, CHU de Toulouse, hôpital Paule-de-Viguier, 31059 Toulouse, France.
| | - F Bayoumeu
- Polyclinique de l'Ormeau, 65000 Tarbes, France
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Gaillard T, Girault A, Alexander S, Goffinet F, Le Ray C. Is induction of labor a reasonable option for breech presentation? Acta Obstet Gynecol Scand 2019; 98:885-893. [PMID: 30723903 DOI: 10.1111/aogs.13557] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Whereas spontaneous onset of labor and vaginal delivery for breech presentation is considered to be a safe and effective option in selected cases, the safety of induction of labor is not established yet. The objectives of this study were to describe the outcomes of pregnancy in women induced with a fetus in breech presentation and compare the outcomes with those undergoing planned cesarean delivery. MATERIAL AND METHODS We performed a secondary analysis of the observational prospective multicenter PREMODA study, including all singleton breech deliveries after 37 weeks in 174 centers in France and Belgium. We excluded women with spontaneous onset of labor, scarred uterus or intrauterine fetal death. Our study population consisted of women with either induction of labor or planned cesarean delivery. The primary outcome was the composite criteria of neonatal mortality and serious morbidity used in the Term Breech Trial and in the PREMODA prospective cohort. RESULTS Our study population consisted of 4138 women, 218 with induction of labor and 3920 with planned cesarean. Two-thirds (67.4%) of the women in the induction of labor group delivered vaginally. There was no significant difference between the groups for the primary outcome (48 [1.2%] in the planned cesarean group vs 3 [1.4%] in the induction of labor group, P = 0.75). Moreover, none of the criteria of the composite primary outcome was significantly more frequent in the induction of labor group. CONCLUSIONS Induction of labor for breech presentation does not seem to increase neonatal mortality or severe neonatal morbidity compared with planned cesarean delivery.
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Affiliation(s)
- Thomas Gaillard
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,DHU Risks in Pregnancy, Paris, France.,Sorbonne Medical Faculty, Paris Descartes University, Paris, France
| | - Aude Girault
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,DHU Risks in Pregnancy, Paris, France.,Sorbonne Medical Faculty, Paris Descartes University, Paris, France.,INSERM, UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - Sophie Alexander
- Perinatal Epidemiology and Reproductive Health Unit, Epidemiology, Biostatistics and Clinical Research Center, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - François Goffinet
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,DHU Risks in Pregnancy, Paris, France.,Sorbonne Medical Faculty, Paris Descartes University, Paris, France.,INSERM, UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - Camille Le Ray
- Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,DHU Risks in Pregnancy, Paris, France.,Sorbonne Medical Faculty, Paris Descartes University, Paris, France.,INSERM, UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
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Sun W, Liu F, Liu S, Gratton SM, El-Chaar D, Wen SW, Chen D. Comparison of outcomes between induction of labor and spontaneous labor for term breech - A systemic review and meta analysis. Eur J Obstet Gynecol Reprod Biol 2018; 222:155-160. [PMID: 29408748 DOI: 10.1016/j.ejogrb.2017.12.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity. METHODS Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included. Perinatal morbidity was calculated by RevMan 5 and presented by pooled odds ratio with 95% confidence intervals. RESULTS Cesarean section rate and neonatal intensive care unit admission were increased in induction of breech labor as compared with spontaneous breech labor. No significant difference in umbilical cord blood base excess ≤ -12 mmol/L, Apgar 5 min < 7, Apgar 5 min < 4, umbilical cord blood PH < 7, neonatology unit admission, maternal fever, and intrapartum stillbirth between the two groups was found. CONCLUSIONS Induction of breech labor has higher cesarean section rate and NICU perinatal morbidity compared to spontaneous breech labor. The neonatal outcomes were otherwise similar across both groups. Eligibility for induction of breech labor needs to be assessed carefully according to individual situation.
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Affiliation(s)
- Wen Sun
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China; OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada
| | - Fen Liu
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China
| | - Shiliang Liu
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China; Public Health Agency of Canada, Ottawa, Canada
| | - Sara-Michelle Gratton
- OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada; Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada
| | - Darine El-Chaar
- OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada; Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada
| | - Shi Wu Wen
- OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada; Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada; School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa Faculty of Medicine, Ottawa, Canada.
| | - Dunjin Chen
- Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China.
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Jarniat A, Eluard V, Martz O, Calmelet P, Calmelet A, Dellinger P, Sagot P. Induced labour at term and breech presentation: Experience of a level IIB French maternity. J Gynecol Obstet Hum Reprod 2017; 46:597-600. [DOI: 10.1016/j.jogoh.2017.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 04/09/2017] [Accepted: 04/12/2017] [Indexed: 11/28/2022]
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Burgos J, Arana I, Garitano I, Rodríguez L, Cobos P, Osuna C, Del Mar Centeno M, Fernández-Llebrez L. Induction of labor in breech presentation at term: a retrospective cohort study. J Perinat Med 2017; 45:299-303. [PMID: 27105484 DOI: 10.1515/jpm-2015-0426] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 03/21/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the outcome of two methods of labor induction and spontaneous onset of labor in breech presentation at term. MATERIAL A retrospective study between 2003 and 2012. We compare obstetric (indication of induction, Bishop score, cesarean rate) and perinatal outcomes (Apgar score, umbilical artery pH, base excess ≤-12 mmol/L, admission to neonatal unit) between prostaglandins and oxytocin. We also compare labor induction versus spontaneous onset of labor. RESULTS Of the 1684 breech deliveries, we carried out labor induction in 221 cases (76% with prostaglandins, 24% with oxytocin). The prostaglandins group had significantly lower Bishop scores and the time for induction phase was significantly higher. There were no differences in cesarean rate between both methods of induction or spontaneous onset of labor. The prostaglandins group had higher rates of base excess ≤-12 mmol/L. Compared with spontaneous onset of labor in breech presentation, induction had significant lower rates of newborn weight and higher rates of admission to the neonatal unit. CONCLUSIONS Induction of labor in breech presentation at term is a reasonable and effective option after a careful selection of cases. It was not associated with an increase of perinatal morbidity or cesarean rate compared with spontaneous onset of labor.
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Affiliation(s)
- Jorge Burgos
- Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces, C/Plaza de Cruces 12, 48903, Baracaldo, Biscay
| | - Itziar Arana
- University of the Basque Country (UPV/EHU), Biscay
| | | | | | | | - Carmen Osuna
- University of the Basque Country (UPV/EHU), Biscay
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Bleu G, Demetz J, Michel S, Drain A, Houfflin-Debarge V, Deruelle P, Subtil D. Effectiveness and safety of induction of labor for term breech presentations. J Gynecol Obstet Hum Reprod 2017; 46:29-34. [DOI: 10.1016/j.jgyn.2015.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/21/2015] [Accepted: 12/18/2015] [Indexed: 11/25/2022]
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Secter MB, Simpson AN, Gurau D, Snelgrove JW, Hodges R, Mocarski E, Pittini R, Windrim R, Higgins M. Learning From Experience: Qualitative Analysis to Develop a Cognitive Task List for Vaginal Breech Deliveries. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 37:966-74. [DOI: 10.1016/s1701-2163(16)30046-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Macharey G, Ulander VM, Heinonen S, Kostev K, Nuutila M, Väisänen-Tommiska M. Induction of labor in breech presentations at term: a retrospective observational study. Arch Gynecol Obstet 2015; 293:549-55. [DOI: 10.1007/s00404-015-3853-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/14/2015] [Indexed: 11/25/2022]
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Balayla J, Dahdouh EM, Villeneuve S, Boucher M, Gauthier RJ, Audibert F, Fuchs F. Obstetrical and neonatal outcomes following unsuccessful external cephalic version: a stratified analysis amongst failures, successes, and controls. J Matern Fetal Neonatal Med 2014; 28:605-10. [DOI: 10.3109/14767058.2014.927429] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Marzouk P, Arnaud E, Oury JF, Sibony O. Induction du travail et présentation du siège : expérience de la maternité de l’hôpital Robert-Debré, Paris. ACTA ACUST UNITED AC 2011; 40:668-74. [DOI: 10.1016/j.jgyn.2011.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 03/18/2011] [Accepted: 03/21/2011] [Indexed: 11/27/2022]
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Kotaska A, Menticoglou S. Singleton Breech at Term: Two Continents, Two Approaches. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010. [DOI: 10.1016/s1701-2163(16)34610-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Kotaska A, Menticoglou S, Gagnon R, Gagnon R, Farine D, Basso M, Bos H, Delisle MF, Grabowska K, Hudon L, Menticoglou S, Mundle W, Murphy-Kaulbeck L, Ouellet A, Pressey T, Roggensack A. Accouchement du siège par voie vaginale. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2009. [DOI: 10.1016/s1701-2163(16)34222-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kotaska A, Menticoglou S, Gagnon R, Gagnon R, Farine D, Basso M, Bos H, Delisle MF, Grabowska K, Hudon L, Menticoglou S, Mundle W, Murphy-Kaulbeck L, Ouellet A, Pressey T, Roggensack A. Vaginal Delivery of Breech Presentation. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2009; 31:557-566. [DOI: 10.1016/s1701-2163(16)34221-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Su M, McLeod L, Ross S, Willan A, Hannah WJ, Hutton E, Hewson S, Hannah ME. Factors associated with adverse perinatal outcome in the Term Breech Trial. Am J Obstet Gynecol 2003; 189:740-5. [PMID: 14526305 DOI: 10.1067/s0002-9378(03)00822-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND In the Term Breech Trial, the risk of adverse perinatal outcome was lower with planned cesarean section versus planned vaginal birth. We undertook secondary analyses to determine factors associated with adverse perinatal outcome. STUDY DESIGN By using multiple logistic regression analyses, we determined the effect of prelabor cesarean section, cesarean section during early labor, cesarean section during active labor versus vaginal birth, and other factors, on adverse perinatal outcome. For 1384 fetuses delivered after labor, we determined the effect of variables associated with labor on adverse perinatal outcome. RESULTS The risk of adverse perinatal outcome was lowest with prelabor cesarean section (odds ratio [OR]=0.13) and highest with vaginal birth. For those delivered after labor, labor augmentation (P=.007), birth weight less than 2.8 kg (P=.003), and longer time between pushing and delivery (P<.001) increased the risk, whereas the presence of an experienced clinician at delivery (P=.004) reduced the risk of adverse perinatal outcome. CONCLUSION Breech infants at term are best delivered by prelabor cesarean section.
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Affiliation(s)
- Min Su
- Department of Obstetrics and Gynecology, Sunnybrook and Women's College Health Sciences Centre
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Abstract
Three percent to 4% of term fetuses will be breech at delivery. Evidence from randomized controlled trials has found a policy of planned cesarean section to be significantly better for the singleton fetus in breech presentation at term compared to a policy of planned vaginal birth. However, some women may wish to avoid cesarean section and for others, cesarean section may not be possible. We undertook this review to identify factors associated with higher and lower risk of adverse fetal or neonatal outcome at term during vaginal breech delivery. We searched MEDLINE from 1966 to 2002 using the search terms vaginal breech delivery and breech presentation and retrieved all relevant articles. We also reviewed personal references and reference lists of articles retrieved. Women who are older or who have a fetus that is either in footling presentation, has a hyperextended head or is estimated to weigh <2500 g or >4000 g may be at higher risk of adverse fetal outcome. Prolonged labor or not having an experienced clinician at vaginal breech birth may also increase the risk. Women with a fetus in breech presentation at term should be offered the option of delivery by planned cesarean section and should be informed that this will reduce their risk of adverse fetal or neonatal outcome. Practitioners should develop and maintain skills at vaginal breech delivery for those women not wishing or not able to be delivered by cesarean section.
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Affiliation(s)
- Modupe O Tunde-Byass
- Department of Obstetrics and Gynaecology, Sunnybrook and Women's College Health Sciences Centre, Maternal Infant and Reproductive Health Research Unit at the Centre for Research in Women's Health, University of Toronto, Toronto, Ontario, Canada
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