Comparison of outcomes between induction of labor and spontaneous labor for term breech – A systemic review and meta analysis

Sun, Wen; Liu, Fen; Liu, Shiliang; Gratton, Sara-Michelle; El-Chaâr, Darine; Wen, Shi Wu; Chen, Dunjin

doi:10.1016/j.ejogrb.2017.12.031

Cited by 19 publications

(10 citation statements)

References 17 publications

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“…One of the essential findings of our study was that the induction of labor did not increase the risks in preterm breech deliveries (24-27 weeks of gestation: aOR 0.50, p value 0.787, 28-32 weeks of gestation: aOR 2.13, p value Contrary findings were found in a recent meta-analysis (2018) as induction of term breech labor was found to increase the risk of perinatal morbidity and cesarean sections [28]. However, Macharey et al found no association between induction of term breech labor and neonatal morbidity, but the rate of vaginal deliveries was remarkably lower if term breech labor was induced compared to the spontaneous breech deliveries [29].…”

Section: Discussioncontrasting

confidence: 77%

Risk factors for adverse outcomes in vaginal preterm breech labor

Toijonen

Heinonen

Gissler

et al. 2020

Arch Gynecol Obstet

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Purpose To assess the risk factors for adverse outcomes in attempted vaginal preterm breech deliveries. Methods A retrospective case-control study, including 2312 preterm breech deliveries (24 + 0 to 36 + 6 gestational weeks) from 2004 to 2018 in Finland. The preterm breech fetuses with adverse outcomes born vaginally or by emergency cesarean section were compared with the fetuses without adverse outcomes with the same gestational age. A multivariable logistic regression analysis was used to calculate the risk factors for adverse outcomes (umbilical arterial pH below 7, 5-min Apgar score below 4, intrapartum stillbirth and neonatal death < 28 days of age).

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Section: Discussioncontrasting

confidence: 77%

Risk factors for adverse outcomes in vaginal preterm breech labor

Toijonen

Heinonen

Gissler

et al. 2020

Arch Gynecol Obstet

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“…The meta-analysis from 2018 did not find any statistically significant differences in pH in the umbilical artery when comparing induced and spontaneous labors. 11 A Dutch population-based study found increased perinatal death when comparing induced breech deliveries with spontaneous breech deliveries. 17 We observed three stillbirths in the group with planned vaginal birth.…”

Section: Discussionmentioning

confidence: 99%

“…IOL has become an accepted procedure in breech presentations in Norway. There is limited evidence, solely from case series, on the safety of breech induction 11,12 . This paper seeks to add to that body of evidence.…”

Section: Introductionmentioning

confidence: 99%

Induction of labor in breech presentations ‐ a retrospective cohort study

Welle-Strand

Tappert

Eggebø

2021

Acta Obstet Gynecol Scand

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Introduction: There is limited evidence on the safety and outcome of induction of breech labor.In this study, we aimed to compare the outcomes of spontaneous and induced breech deliveries and to describe variations in induction rates. Material and methods:This was a retrospective cohort study comprising 1054 singleton live fetuses in breech presentation at Trondheim University Hospital from 2012 to 2019. The main outcome was intrapartum cesarean section, and secondary outcomes were postpartum hemorrhage, anal sphincter ruptures, Apgar scores, pH in the umbilical artery and metabolic acidosis. All data were obtained from the hospital birth journal.Results: Induction of labor was performed in 127/606 (21.0%) of women with planned vaginal birth. The frequency of intrapartum cesarean section was 48.0% for induced labor vs 45.7% for spontaneous labor (p=0.64). We found no differences in the frequency of postpartum hemorrhage or anal sphincter ruptures between induced and spontaneous births. The median pH in the umbilical artery was significantly lower in neonates with induced labor compared with neonates with spontaneous labor (7.22 vs 7.25; p=0.02). The frequency of pH <7.05 was 7.0% for induced labor vs 2.9% (p= 0.05) for spontaneous labor, but the frequency of pH <7.0 was not significantly different: 2.6% vs 0.8% (p=0.14), respectively. Three neonates with planned vaginal birth had metabolic acidosis: two with spontaneous labors and one with induced labor. Three fetuses with planned vaginal birth died during labor: two with spontaneous onset of labor and one with induced labor. All three were extremely preterm: two were delivered in week 23 and one in week 25. We did not observe any significant trend in induction rates in either parous or in nulliparous women. Conclusions:The induction rates were stable during the study period. We did not observe any significant difference in intrapartum cesarean section rates, in the frequency of pH <7.0 in the umbilical artery, or in the frequency of metabolic acidosis when comparing induced and spontaneous breech deliveries.

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“…Women should be informed about the three to four times increased risk of low Apgar score associated with vaginal breech delivery in general, and increased risk of low pH, and possibly increased risk of cesarean section and neonatal admission in particular, for induction. Jeppe B. Schroll 1,2…”

Section: Breech and Induction Time For Evidence-based Informed Consentmentioning

confidence: 99%