Breech presentation management: A critical review of leading clinical practice guidelines

Morris, Sara; Geraghty, Sadie; Sundin, Deborah

doi:10.1016/j.wombi.2021.06.011

Cited by 9 publications

(7 citation statements)

References 35 publications

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“…Morris et al 4 describe how women understood that the diagnosis of a breech presentation would change their pregnancy and birth experience. The findings of this review depict diagnosis of breech presentation as a stressful event in the current maternity and societal climate due to persistent negative attitudes, despite the small actual risk of planning a VBB 27 . Clinicians are vital in aiding women in navigating changes to their pregnancy and birth experiences 50 , for example upon the diagnosis of a breech presentation.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical practice guidelines support the skill development of both midwives and obstetricians in VBB 27 - 29 . A Delphi study exploring breech presentation reported that participants endorsed breech birth being taught as a ‘normal’ skill instead of an emergency event 30 .…”

Section: Discussionmentioning

confidence: 99%

“…Midwives in Sloman et al 25 felt this was an inappropriate approach to teaching breech skills and could lead to panic in clinicians and likely interrupts physiological birth processes. Clinical practice guidelines support the skill development of both midwives and obstetricians in VBB [27][28][29] . A Delphi study exploring breech presentation reported that participants endorsed breech birth being taught as a 'normal' skill instead of an emergency event 30 .…”

Section: The Breech Dichotomy and Clinicians' Experiences (Or Lack Th...mentioning

confidence: 99%

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Women’s experiences of breech birth decision making: An integrated review

2022

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INTRODUCTION Currently, caesarean section is the primary mode of birth for a breech presenting fetus, leading to a deskilling of clinicians and limitation of birth choices for women. The aim of this review is to present a synthesized summary of existing literature related to women’s experiences of breech birth mode decision-making. METHODS A systematic search of the literature was conducted in April 2021, utilizing five databases to identify and obtain peer-reviewed articles meeting the predetermined selection criteria. RESULTS Four major categories were synthesized from the integrated review: 1) Women who desire a vaginal birth may experience a range of negative emotions such as feelings of disempowerment, loss, uncertainty and a sense of isolation; 2) Women who experience a breech presentation at term experience significant pressures to conform to expectations of medical professionals and their families due to perceptions of risk related to breech birth; 3) Breech birth decision-making in a limiting system; and 4) Overall satisfaction with the decision to plan a vaginal breech birth. CONCLUSION Women with a breech presenting fetus at term experience a complex range of emotions and internal and external pressures due to perceptions of risk around breech birth. Midwives were seen as helpful throughout the breech experience. The reduced caesarean section rate for breech, observed in studies exploring specialized care pathways or dedicated services, could reduce the incidence of Severe Acute Maternal Morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: The Breech Dichotomy and Clinicians' Experiences (Or Lack Th...mentioning

confidence: 99%

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Women’s experiences of breech birth decision making: An integrated review

2022

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“…However, due to the retrospective study design, we do not know which maneuvers if any, were used. International clinical practice guidelines recommend avoiding traction in the active second stage of vaginal delivery, but any specific maneuver is not favored [26]. In future studies, BPP in breech deliveries and difficulties with delivering the head should be specifically assessed.…”

Section: Discussionmentioning

confidence: 99%

Birth injury in breech delivery: a nationwide population-based cohort study in Finland

Kekki

Koukkula

Salonen

et al. 2022

Arch Gynecol Obstet

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Purpose Previous studies have examined the optimal mode of breech delivery extensively, but there is a scarcity of publications focusing on the birth injuries of neonates born in breech presentation. This study aimed to examine birth injury in breech deliveries. Methods In this retrospective register-based nationwide cohort study, data on birth injuries in vaginal breech deliveries with singleton live births were compared to cesarean section with breech presentation and cephalic vaginal delivery between 2004 and 2017 in Finland. The data were retrieved from the National Medical Birth Register. Primary outcome variables were severe and mild birth injury. Incidences of birth injuries in different gestational ages and birthweights were calculated in different modes of delivery. Crude odds ratios of risk factors for severe birth injury were analyzed. Results In vaginal breech delivery (n = 4344), there were 0.8% of neonates with severe birth injury and 1.5% of neonates with mild birth injury compared to 0.06% and 0.2% in breech cesarean section (n = 16,979) and 0.3% and 1.9% in cephalic vaginal delivery (n = 629,182). Brachial plexus palsy was the most common type of injury in vaginal breech delivery. Increasing gestational age and birthweight had a stronger effect on the risk for injury among cephalic vaginal deliveries than among vaginal breech deliveries. Conclusion Birth injuries were rare in vaginal breech deliveries. The incidence of severe birth injury was two times higher in vaginal breech delivery compared to cephalic vaginal delivery. Brachial plexus palsy was the most common type of injury in vaginal breech delivery.

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“…Nustatyta, kad gimdymas natūraliais gimdymo takais (angl. Vaginal Breech Birth, VBB) yra saugus būdas, jei jis atitinka reikiamus kriterijus ir prižiūrimas patyrusių specialistų [7]. Išorinis vaisiaus apgręžimas bei gimdymas vaginaliniu būdu, esant vaisiaus sėdmenų pirmeigai, turi būti atliekamas tik tose ligoninėse, kuriose yra galimybė atlikti cezario pjūvio operaciją [8].…”

Section: Rezultatai Ir Jų Aptarimasunclassified

Išorinio Vaisiaus Apgręžimo Efektyvumas, Esant Vaisiaus Sėdmenų Pirmeigai

Slauzgalvytė¹,

Stankutė²,

Gerulskytė³

2022

Health Sciences

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Išorinis vaisiaus apgręžimas (IVA), esant vaisiaus sėdmenų pirmeigai, yra vienas iš alternatyvių būdų siekiant sumažinti nebūtinų cezario pjūvio operacijų (CPO) skaičių [1]. Atliktų tyrimų duomenimys parodė, jog nediagnozavus vaisiaus sėdmenų pirmeigos iki gimdymo, didėja perinatalinio sergamumo ir mirtingumo rizika [2]. Klinikinėje praktikoje IVA turėtų būti siūlomas, jei vaisiaus sėdmenų pirmeiga išlieka nuo 36+0 gestacinės savaitės ir nėra kontraindikacijų atlikti šį metodą. Vaisiaus sėdmenų pirmeiga nustatoma 3-4 proc. visų nėštumų, o sėkmingo IVA dažnis siekia iki 58 procentų [3].

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Breech presentation management: A critical review of leading clinical practice guidelines

Cited by 9 publications

References 35 publications

Women’s experiences of breech birth decision making: An integrated review

Women’s experiences of breech birth decision making: An integrated review

Birth injury in breech delivery: a nationwide population-based cohort study in Finland

Išorinio Vaisiaus Apgręžimo Efektyvumas, Esant Vaisiaus Sėdmenų Pirmeigai

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