Breech delivery and epidural analgesia

Chadha, Yogesh; Mahmood, Tahir; Dick, Michael; Smith, Norman C.; Campbell, Doris M.; Templeton, Allan

doi:10.1111/j.1471-0528.1992.tb14462.x

Cited by 37 publications

(18 citation statements)

References 22 publications

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“…Earlier studies have shown that epidural anesthesia in connection with breech delivery is associated with a longer duration of labor and an increased need for augmentation of labor with oxytocin infusion [28]. It is not possible to tell whether the association between epidural anesthesia and adverse outcome is due to the epidural prolonging labor and delaying expulsion of the fetus or whether epidural anesthesia is simply used more in prolonged labors that inherently have a higher risk of expulsive delay and adverse outcome [11].…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Macharey

Gissler

Ulander

et al. 2017

BMC Pregnancy Childbirth

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BackgroundVaginal breech delivery is associated with adverse perinatal outcome. The aim of this study was to identify factors associated with adverse perinatal outcome in term breech pregnancies, and to provide clinicians an aid in selecting women for a trial of vaginal labor with the fetus in breech position.MethodsWe conducted a retrospective, nationwide, Finnish population-based case-control study. All planned singleton vaginal deliveries at term with the fetus in breech position between the years 2005 and 2014 were analyzed. The study’s end point was a composite set of adverse perinatal outcomes. All infants with an adverse outcome were compared to the infants with normal outcomes. A multivariate logistic regression model was used to analyze the data.ResultsAn adverse perinatal outcome was recorded for 73 (1.5%) infants. According to the study results fetal growth restriction (adjusted odds ratio, 2.94; 95% CI, 1.30–6.67), oligohydramnios (adjusted odds ratio, 2.94; 95% CI, 1.15–7.18), a history of cesarean section (adjusted odds ratio, 2.94; 95% CI, 1.28–6.77, gestational diabetes (adjusted odds ratio, 2.89; 95% CI, 1.54–5.40), epidural anesthesia (adjusted odds ratio, 2.20; 95% CI, 1.29–3.75) and nulliparity (adjusted odds ratio, 1.84; 95% CI, 1.10–3.08) were associated with adverse perinatal outcome.ConclusionsAdverse perinatal outcome in planned vaginal breech labor at term is associated with fetal growth restriction, oligohydramnios, previous cesarean delivery, gestational diabetes, nulliparity and epidural anesthesia.

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Section: Discussionmentioning

confidence: 99%

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Macharey

Gissler

Ulander

et al. 2017

BMC Pregnancy Childbirth

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“…Recently Chadha et al (1992) have shown that women admitted in labour with breech presentation at a low cervical dilatation (less than 3 cm) are more likely to be delivered by caesarean section. This is in agreement with our study.…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed breech

Nwosu¹,

Walkinshaw²,

Chia³

et al. 1993

BJOG

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Objectives To assess the proportion of breech presentations diagnosed in labour and to compare their outcomes with those diagnosed prior to the onset of labour. Design Retrospective casenote review. Setting Mill Road Maternity Hospital, a teaching hospital in central Liverpool. Subjects Three hundred and five singleton breech presentations delivered in the hospital between January 1988 and July 1991; 226 cases prior to the onset of labour and 79 cases diagnosed for the first time in labour. Main outcome measures Rates of vaginal delivery and caesarean section, birthweight, short term morbidity as assessed by trauma, signs of cerebral irritation and admission to the newborn intensive care unit (NBICU), and Apgar scores. Results Breech presentations diagnosed for the first time in labour were more likely to deliver vaginally than those assessed and allowed to go into labour (odds ratio 1:68 95% CI 1.0–3.0). This difference was not due to demographic variables or differences in birthweight. There was no short term morbidity attributable to vaginal breech delivery. Conclusion A significant number of breech presentations are not detected until labour despite rigorous antenatal surveillance. Our results show that undiagnosed breeches may not be important as they are more likely to deliver vaginally, with no excess morbidity or mortality, compared to diagnosed breeches in labour, carefully assessed for vaginal delivery. There are, therefore, no grounds for delivering all undiagnosed breeches by caesarean section.

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“…77 They observed that epidural was associated with over a fivefold increase in caesarean section in the second stage of labour (odds ratio 5.4, 95% CI 2.5 -12.0). In a very large retrospective study from the United Kingdom, Chadha et al concluded that epidural analgesia was associated' with longer labours, increased requirement for augmentation, and increased caesarean section.…”

Section: Use Of Epidural Analgesia With Vaginal Birth After Caesareanmentioning

confidence: 98%

The effect of epidural analgesia on labour progress and mode of delivery

Thorp

Nielsen

1996

Fet. Matern. Med. Rev.

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The use and method of intrapartum obstetric analgesia has remained controversial since the late 16th Century. In 1591, during the reign of James, VI, Eufame MacCalzean (a Scottish midwife) was the first to attempt pain relief during labour and childbirth. At that time, the provision of pain relief during labour was an unacceptable medical practice due mainly to religious and social objections. Because of these objections, and historical accounts that claimed the midwife had consulted with a witch during the delivery, both MacCalzean and the midwife were found guilty of witchcraft and subsequently executed.

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Breech delivery and epidural analgesia

Cited by 37 publications

References 22 publications

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Undiagnosed breech

The effect of epidural analgesia on labour progress and mode of delivery

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