Breech presentation – an analysis of resultsin one perinatal center
Authors:
J. Siváková 1; K. Biringer 1; M. Hrtánková 1; P. Šumichrastová 1; E. Kúdela 1; Š. Sivák 2; I. Švecová 1; J. Danko 1
Authors‘ workplace:
Gynekologicko-pôrodnícka klinika, Jesseniova lekárska fakulta UK, Univerzitná nemocnica, Martin, Slovensko, prednosta prof. MUDr. J. Danko, CSc.
1; Neurologická klinika, Jesseniova lekárska fakulta UK, Univerzitná nemocnica, Martin, Slovensko
2
Published in:
Ceska Gynekol 2014; 79(2): 107-114
Overview
Objective:
A retrospective analysis of medical records during years 2007–2011 considers maternal and fetal outcome in patients with breech presentation terminated by vaginal delivery versus caesarean section (CS).
Design:
Retrospective analysis.
Setting:
Department of Gynecology and Obstetrics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic.
Methods:
Authors devided patients with breech presentation of fetus (n = 299) to groups of single pregnancies terminated in term (n = 197), before term (n = 67) and to group of multiple pregnancies (n = 35). All groups were devided according to the way of termination of pregnancy by vaginal delivery, by acute CS and by planned CS. Main followed parameters: parity, gestational week, Apgar score, birth weight, birth length, fetal gender, indications for CS, mortality and neonatal morbidity, umbilical artery pH, convulsions, admit to neonatal intensive care unit, intubation of neonate, intracranial bleeding, cervical spine and peripheral nerve injuries.
Results:
Total cohort of breech deliveries was 299. In the group of single pregnancies in term was 19.8% terminated by vaginal delivery (n = 39), 32.5% deliveries by acute CS (n = 64). The most common indication was fetal hypoxia (43.8%). By planned CS was terminated 47.7% deliveries (n = 94). The most common indication for CS was footling presentation (54.3%). Severe neonatal morbidity was rare and without significant difference according to the type of termination of pregnancy. Neonatal outcome was comparable in the group of preterm deliveries(n = 67) terminated by vaginal delivery or by CS. All neonatal deaths were associated with extreme prematurity and not with type of termination of gravidity.
Conclusion:
Clinical outcomes between vaginal breech deliveries and breech deliveries terminated by CS in term in singleton pregnancies were not significant different. Mortality of neonates delivered by preterm delivery was associated with severe prematurity.
Keywords:
breech delivery, vaginal delivery, caesarean section, injury
Sources
1. Albrechtsen, S., Rasmussen, S., Reigstad, H., et al. Evaluation of a protocol for selecting fetuses in breech presentation for vaginal delivery or cesarean section. Am J Obstet Gynecol, 1997, 177, p. 586–592.
2. Bergenhenegouwen, LA., Meertens, LJ., Schaaf, J., et al. Vaginal delivery versus caesarean section in preterm breech delivery: a systematic review. Eur J Obstet Gynecol Reprod Biol, 2013.
3. Bracht, DPE. (1882—1969) of Berlin and his ‘‘breech’’ manoeuvre. Archives of Disease in Childhood: Fetal and Neonatal Edition [serial on the Internet] 2003:88. Dostupné na internete: http://0- fn.bmj.com.library.newcastle.edu.au/content/88/1/F76.long.
4. Carayol, M., Blondel, B., Zeitlin, J., et al. Changes in the rates of caesarean delivery before labour for breech presentation at term in France: 1972–2003. Eur J Obstet Gynecol Reprod Biol, 2007, 132, p. 20–26.
5. Demirci, O., Tuğrul, AS., Turgut, A., et al. Pregnancy outcomes by mode of delivery among breech births. Arch Gynecol Obstet, 2012, 285, p. 297–303.
6. Giuliani, A., Schöll, WM., Basver, A., Tamussino, KF. Mode of delivery and outcome of 699 term singleton breech deliveries at a single center. Am J Obstet Gynecol, 2002, 187, p. 1694–1698.
7. Glezerman, M. Five years to the Term Breech Trial: the rise and fall of a randomized controlled trial. Am J Obstet Gynecol, 2006, p. 20–25.
8. Goffinet, F., Carayol, M., Foidart, JM., et al. Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Obstet Gynecol, 2006, 194, p. 1002–1011.
9. Hannah, ME., Hannah, WJ., Hewson, SA., et al. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet, 2000, 21, 356, 9239, p. 1375–1383.
10. Hellsten, C., Lindqvist, PG., Olofsson, P. Vaginal breech delivery: is it still an option? Eur J Obstet Gynecol Reprod Biol, 2003, 111, p. 122–128.
11. Cheng, M., Hannah, M. Breech delivery at term: a critical review of the literature. Obstet Gynecol, 1993, 82, p. 605–618.
12. Kayem, G., Goffinet, F., Clément, D., et al. Breech presentation at term: morbidity and mortality according to the type of delivery at Port Royal Maternity hospital from 1993 through 1999. Eur J Obstet Gynecol Reprod Biol, 2002, 102, p. 137–142.
13. Kayem, G., Baumann, R., Goffinet, F., et al. Early preterm breech delivery: is a policy of planned vaginal delivery associated with increased risk of neonatal death? Am J Obstet Gynecol, 2008, 198, p. 289.e1-6.
14. Kotaska, A., Menticoglou, S., Gagnon, R. SOGC clinical practice guideline: Vaginal delivery of breech presentation: no. 226, June 2009. Int J Gynaecol Obstet, 2009, 107, p. 169–176.
15. Rietberg, CC., Elferink-Stinkens, PM., Brand, R., et al. Term breech presentation in The Netherlands from 1995 to 1999: mortality and morbidity in relation to the mode of delivery of 33824 infants. BJOG, 2003, 110, p. 604–609.
16. Rietberg, CC., Elferink-Stinkens, PM. , Visser, GH. The effect of the Term Breech Trial on medical intervention behaviour and neonatal outcome in The Netherlands: an analysis of 35,453 term breech infants. BJOG, 2005, 112, p. 205–209.
17. Steins Bisschop, CN., Vogelvang, TE., May, AM., Schuitemaker, NW. Mode of delivery in non-cephalic presenting twins: a systematic review. Arch Gynecol Obstet, 2012, 286, p. 237–247.
18. Stuart, IP. Term breech trial. Lancet, 2001, 357, p. 228.
19. Sullivan, EA., Moran, K., Chapman, M. Term breech singletons and caesarean section: a population study, Australia 1991-2005. Aust N Z J Obstet Gynaecol, 2009, 49, 5, p. 456–460.
20. Unzeitig, V., Binder, T., Velebil, P. Doporučený postup při vedení prenatální péče a porodu donošeného plodu v poloze podélné koncem pánevním. Čes Gynek, 70, 2005, 6, s. 462.
21. Whyte, H., Hannah, ME., Saigal, S., et al. Term Breech Trial Collaborative Group. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. Am J Obstet Gynecol, 2004, 191, p. 864–871.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2014 Issue 2
Most read in this issue
- Role of prebioptic and bioptic methodsin the screening and diagnosis of cervical cancer
- Intrauterine fetal death syndrom: analysis of cases from 2008 to 2012 in Institute for the care of mother and child
- New views on the functional morphology of human clitoris
- Breech presentation – an analysis of resultsin one perinatal center