Comparison of fetal outcome in premature vaginal or cesarean breech delivery at 24–37 gestational weeks

Vidovics, M; Jacobs, Volker R.; Fischer, Thorsten; Maier, Bárbara

doi:10.1007/s00404-014-3203-y

Cited by 11 publications

(6 citation statements)

References 30 publications

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“…In addition, our results showed no difference in the arterial umbilical pH between the groups, which indicates that acidosis was not increased after vaginal breech labor. This is in contrary to the venous umbilical pH and base excess results of Vidovics and colleagues (2014) who compared outcomes of preterm breech neonates delivered vaginally or by cesarean section at 24–37 gestational weeks [ 22 ]. However, low patient numbers in their study did not enable further statistical analysis.…”

Section: Discussionmentioning

confidence: 85%

Neonatal outcome in vaginal breech labor at 32 + 0—36 + 0 weeks of gestation: a nationwide, population-based record linkage study

Toijonen

Heinonen

Gissler

et al. 2022

BMC Pregnancy Childbirth

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Background In many countries, vaginal breech labor at term is an option in selected cases. However, the safety of vaginal breech labor in preterm is still unclear. Therefore our study aimed to evaluate the safety of vaginal breech labor in late preterm deliveries. Design A retrospective register-based study. Setting Maternity hospitals in Finland, 2004–2017. Participants The study population included 762 preterm breech deliveries at 32 + 0—36 + 6 gestational weeks according to the mode of delivery, 535 (70.2%) of them were born vaginally in breech presentation, and 227 (29.8%) were delivered by non-urgent cesarean section. Methods The study compared short-term neonatal adverse outcomes of singleton vaginal breech deliveries with non-urgent cesarean deliveries at 32 + 0 to 36 + 6 weeks of gestation. An odd ratio with 95% confidence intervals was calculated to estimate the relative risk of adverse outcomes. Outcome measures Neonatal death, an arterial umbilical pH below seven, a five-minute Apgar score below four and seven, admission to neonatal intensive care unit, neonatal intubation, neonatal antibiotic therapy, neonatal birth trauma, respiratory distress syndrome, neonatal convulsions, cerebral ischemia, hypoxic-ischemic encephalopathy, congenital hypotonia, and a composite of severe adverse outcomes. Results A five-minute Apgar scores below seven were increased in vaginal breech labor at 32 + 0 to 36 + 6 weeks of gestation compared to non-urgent cesarean sections (aOR 2.48, 95% CI 1.08–5.59). Neonatal antibiotic therapy, the admission to neonatal intensive care unit, and neonatal respiratory distress syndrome were decreased after vaginal breech labor compared to the outcomes of non-urgent cesarean section (neonatal antibiotic therapy aOR 0.60, 95% CI 0.40–0.89; neonatal NICU admission aOR 0.47, 95% CI 0.33–0.68; respiratory distress syndrome aOR 0.30, 95% CI 0.19–0.48). Conclusion Vaginal breech labor at 32 + 0—36 + 6 gestational weeks does not increase severe neonatal short-term morbidity or mortality compared to cesarean section.

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Section: Discussionmentioning

confidence: 85%

Neonatal outcome in vaginal breech labor at 32 + 0—36 + 0 weeks of gestation: a nationwide, population-based record linkage study

Toijonen

Heinonen

Gissler

et al. 2022

BMC Pregnancy Childbirth

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“…According to the Centers for Disease Control (CDC)'s National Center for Health Statistics (NCHS), the rate of CS for early preterm neonates is 32.3% as of 2011 [13]. Various sources in the literature document a correlation between CS and the development of respiratory distress in newborns [14][15][16]. In contrast, studies have also documented no statistically significant association between CS and the incidence of respiratory distress [9].…”

Section: Discussionmentioning

confidence: 99%

Fetal Outcomes in Preterm Cesarean Sections

Rahman¹,

Ullah²,

Ali³

et al. 2022

Cureus

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IntroductionNeonatal mortality is a major challenge in low-middle-income countries. The current study was conducted to assess the association between preterm cesarean delivery and fetal outcomes. MethodsA prospective study was conducted at the Combined Military Hospital in Peshawar, Pakistan, from October 1, 2020, to March 31, 2021. All women reporting to the hospital with a cephalic presentation and singleton pregnancies between the 27th and 34th weeks of gestation were included in the study. Pregnancies with an abnormal presentation, those diagnosed with a congenital abnormality, and those with indications for growth restriction or preterm delivery were excluded from the study. We also excluded infants delivered via vacuum or forceps. The outcomes of interest in this study included neonatal death prior to discharge, neonatal respiratory distress, sepsis, intraventricular hemorrhage (IVH), seizure, subdural hemorrhage (SDH), or appearance, pulse, grimace, activity, and respiration (APGAR) test score of less than 7 at five minutes. Maternal features including diabetes, hypertension and gestational age of delivery, parity, previous cesarean sections (CS), and last pregnancy outcomes were documented in a predefined pro forma. ResultsOur sample size consisted of 288 women, who were classified into two groups. Group A comprised 144 women who gave birth vaginally and group B consisted of 144 women who underwent CS. It was observed that women who underwent cesareans had a higher likelihood of a history of hypertension and related pathologies. It was also observed that these women had a greater likelihood of being of higher age compared to women who underwent vaginal deliveries. Neonates of women who had CS were at a greater risk of presenting with respiratory distress than those who had spontaneous vaginal deliveries. ConclusionBased on our findings, respiratory distress was significantly more common in babies of women who delivered via CS. However, there was no difference in neonatal outcomes in terms of IVH, seizures, SDH, and APGAR score of <7.

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“…Breech presentation occurs in 3% to 5% of all single pregnancies. The frequency is even higher in single preterm deliveries (10% to 15%) and twin pregnancies (25%) [30]. Breech presentation is associated with poorer perinatal and neonatal outcomes and is an independent risk factor for a higher neonatal mortality rate [31].…”

Section: Discussionmentioning

confidence: 99%

Femoral Fracture During Cesarean Section: A Case of Professional Liability? Case Presentation and Review of the Literature

Papi¹,

Gori²,

Turco³

et al. 2019

Arch Clin Med Case Rep

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Breech foetuses are commonly delivered via caesarean section to prevent trauma and decrease the risk of head entrapment, though extraction by abdominal route can very rarely lead to traumatic femur fracture. Typical site of fracture is femoral diaphysis. Although femur fracture is a relatively rare complication, it represents one of the most common fractures of the lower extremity presenting in newborns. A 3900 g female child born at 39 weeks of gestation by caesarean section, presented swelling and tenderness of the left lower extremity in the second day of life. There was no apparent bone disorder predisposing to femur fracture. Fracture of left diaphysis was successfully treated by immobilization with Pavlik harness, healing in a good position for 23 days. Three months after birth, radiogram revealed regular bone consolidation and fracture fully welded. One year after birth, both lower limbs showed a proper mobility with no dysmetria. Caesarean delivery reduces increasingly traumatic complications, especially in breech delivery compared with vaginal delivery, but does not eliminate possible accidental injuries of the newborn. Predisposing factors are many, especially breech presentation and foetuses with malpresentation.Clinicians must be aware that abdominal delivery does not preclude the occurrence of femur fractures.

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Comparison of fetal outcome in premature vaginal or cesarean breech delivery at 24–37 gestational weeks

Abstract: Although general recommendations regarding a superior mode of delivery for improved fetal outcome of preterm breech infants cannot be given, these data do not support a policy of routine CS.

Cited by 11 publications

References 30 publications

Neonatal outcome in vaginal breech labor at 32 + 0—36 + 0 weeks of gestation: a nationwide, population-based record linkage study

Neonatal outcome in vaginal breech labor at 32 + 0—36 + 0 weeks of gestation: a nationwide, population-based record linkage study

Fetal Outcomes in Preterm Cesarean Sections

Femoral Fracture During Cesarean Section: A Case of Professional Liability? Case Presentation and Review of the Literature

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