Jennewein L, Brüggmann D, Fischer K, Raimann FJ, Pfeifenberger HR, Agel L, Zander N, Eichbaum C, Louwen F. Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience-A FRABAT Prospective Cohort Study.
J Clin Med 2021;
10:2117. [PMID:
34068873 PMCID:
PMC8153626 DOI:
10.3390/jcm10102117]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND
Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery into obstetricians' daily practice, we need to gather knowledge from facilities who teach specialized obstetrical management.
METHODS
We performed a prospective cohort study on 140 vaginal deliveries out of breech presentation solely-managed by seven newly-trained physicians and compared fetal outcome as well as rates of manual assistance in respect to preexisting experience.
RESULTS
Fetal morbidity rate measured with a modified PREMODA score was not significantly different in three sub-cohorts sorted by preexisting expertise levels of managing obstetricians (experience groups EG, EG0: 2, 5%; EG1: 3, 7.5%; EG2: 1, 1.7%; p = 0.357). Manual assistance rate was significantly higher in EG1 (low experience level in breech delivery and only in dorsal position) compared to EG0 and EG2 (EG1 28, 70%; EG0: 14, 25%; EG2: 21, 35%; p = 0.0008).
CONCLUSIONS
Our study shows that vaginal breech delivery with newly-trained obstetricians is a safe option whether or not they have advanced preexisting expertise in breech delivery. These data should encourage implementing vaginal breech delivery in clinical routine.
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