Delivery of Breech Presentation at Term Gestation in Canada, 2003–2011

Lyons, Janet; Pressey, Tracy; Bartholomew, Sharon; Liu, Shiliang; Liston, Robert; Joseph, K. S.

doi:10.1097/aog.0000000000000794

Cited by 45 publications

(15 citation statements)

References 22 publications

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“…Studies 2,3,4,29,30,31 have reported better neonatal morbidity in the form of low apgar scores, neonatal intensive care admissions, birth trauma in breech born by elective caesarean section and recommend caesarean section for breech. On the contrary, several authors have reported good neonatal outcomes win patients undergoing vaginal breech birth.…”

Section: Discussionmentioning

confidence: 99%

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Wasim

Wasim²,

Majrooh³

2017

Annals KEMU

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Objectives: To determine fetomaternal outcome in patients undergoing planned vaginal breech delivery at term. Methods:It was a descriptive cross sectional study conducted at Lady Aitchison hospital, Lahore for one and a half year from July 2012 to December 2013. All patients presenting with term breech presentation were included. Fetomaternal outcome in terms of successful vaginal delivery, maternal complications of operative delivery, PPH, wound infection and fetal complications of apgar score of less than five minutes, nursery admission, trauma during delivery (bone fracture, intra cranial hemorrhage) and perinatal mortality was studied.Results: 375 patients delivered as breech presentation during the study period. Out of 375 patients, 155 patients were selected for vaginal birth. Out of these, 65% had successful vaginal delivery, rest had emergency caesarean section due to fetal distress, cord prolapse, dysfunctional labour. 6.4% patients had wound infection and 3.2% had PPH. Booking status was significantly important in patients who had successful vaginal delivery as 80% were booked (p = 0.001). There was no maternal mortality in these patients. Perinatal outcome was good in 87% of patients. 20 fetuses had Apgar score less than 7/min and required nursery admission. Two babies expired due to birth asphyxia and rest were discharged home in satisfactory condition. Conclusion: Although delivery of breech remains a dilemma, the plan of delivery should be individualized. Proper selection of cases with proper antenatal and intrapartum care can result in successful breech vaginal delivery without compromising feto maternal wellbeing and curtailing the percentage of caesarean being done for this malpresentation.

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Section: Discussionmentioning

confidence: 99%

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Wasim

Wasim²,

Majrooh³

2017

Annals KEMU

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“…Further population-based studies, however, have suggested varying levels of benefit in improved outcomes compared to the term breech trial. These real-world clinical findings suggest that, in a system where vaginal breech delivery is widespread, the difference in outcomes between vaginal and caesarean delivery can be small, while these differences are more stark in a setting where the rate of vaginal breech delivery is small 4 5. The term breech trial was widely credited as the death knell for vaginal breech delivery, with its findings being adopted with an exceptional level of acceptance within the obstetric community and hence caesarean delivery has become the standard method of delivery for breech presenting infants.…”

mentioning

confidence: 99%

“…The most up to date reports now suggest that in large cohort studies based in large centres in the developed world, the number of breeches delivered vaginally at term is now approximately 3% 5 15. This extremely low rate of vaginal delivery is largely as a result of a policy of ‘no-option’ of vaginal breech delivery, particularly in nulliparous patients.…”

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confidence: 99%

Trends in vaginal breech delivery

Hehir

2015

J Epidemiol Community Health

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“…This could be due to a follow-up study by Whyte et al which found no difference with regard to death or neurological developmental delay between children in breech presentation delivered vaginally or by C-section by the time the children were two years old [36]. A Canadian study found significantly higher morbidity and mortality rates with higher vaginal delivery rates of breech presentations (≥ 37 GW) compared to delivery by planned C-section [37]. In contrast, Maier et al found only minor differences in neonatal outcomes (UApH values, base excess, Apgar scores, birth trauma, transfers to the intensive care unit) between vaginal deliveries and delivery by C-section.…”

Section: Risk Factors For C-sectionmentioning

confidence: 96%

Can the Rate of C-sections Performed in a Level I Perinatal Center Be Reduced? – An Analysis of the University Gynecology Clinic Rostock, 2008 – 2014

Genuttis

Bolz

Briese

2017

Geburtshilfe Frauenheilkd

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Introduction In Germany the rate of deliveries by cesarean section is continually increasing. Many different reasons have been put forward to explain this trend. The aim of this study was to examine how the C-section rate developed at the University Gynecology Clinic Rostock, one of the biggest maternity hospitals and level I perinatal centers in Germany, based on various maternal and neonatal parameters. The aim was also to identify potential risk factors for C-sections. Material and Method Various obstetric parameters were obtained from the birth cohort (2008 to 2014; n = 20 091) of the University Gynecology Clinic Rostock. The data was used to calculate parameter-specific C-section rates. Potential risk factors for C-section were identified by regression analysis. Results The C-section rate dropped from 26.24% to 23.57%. The rate of repeat C-sections also declined. The mean age of the pregnant women increased. Nevertheless, the frequency of cesarean sections in pregnant women aged more than 35 years declined. Rates of being overweight or obese preconception increased. C-section rates increased as BMI values preconception increased. There was a perceptible trend towards attempting the vaginal delivery of children in breech presentation and of twins. The frequency of depressed neonates after vaginal delivery and after C-section decreased. Rates for mild and advanced acidosis increased after both C-sections and vaginal deliveries. Previous C-section, older maternal age, overweight and obesity prior to conception, breech presentation and multiple pregnancies all increased the risk of cesarean sections. Conclusion This study showed that reducing the rates of C-sections without a deterioration in neonatal outcomes can be achieved even in a large maternity hospital that cares for many high-risk pregnancies.

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Delivery of Breech Presentation at Term Gestation in Canada, 2003–2011

Abstract: II.

Cited by 45 publications

References 22 publications

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Trends in vaginal breech delivery

Can the Rate of C-sections Performed in a Level I Perinatal Center Be Reduced? – An Analysis of the University Gynecology Clinic Rostock, 2008 – 2014

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