Outcome of small for gestational age-fetuses in breech presentation at term according to mode of delivery: a nationwide, population-based record linkage study

Hinnenberg, Pia; Toijonen, Anna; Gissler, Mika; Heinonen, Seppo; Macharey, Georg

doi:10.1007/s00404-019-05091-2

Cited by 10 publications

(15 citation statements)

References 24 publications

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“…Furthermore, fetal growth restriction is The determinants of breech presentation by gestational age. PPROM preterm premature rupture of membranes, PROM premature rupture of membranes known to be the single largest factor for stillbirth and neonatal mortality [26][27][28][29][30]. Maternal arterial hypertension disturbs placental function which might cause low birth weight [31,32].…”

Section: Discussionmentioning

confidence: 99%

A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case–control study

Toijonen

Heinonen

Gissler

et al. 2019

Arch Gynecol Obstet

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Purpose To determine if the common risks for breech presentation at term labor are also eligible in preterm labor. Methods A Finnish cross-sectional study included 737,788 singleton births (24-42 gestational weeks) during 2004-2014. A multivariable logistic regression analysis was used to calculate the risks of breech presentation. Results The incidence of breech presentation at delivery decreased from 23.5% in pregnancy weeks 24-27 to 2.5% in term pregnancies. In gestational weeks 24-27, preterm premature rupture of membranes was associated with breech presentation. In 28-31 gestational weeks, breech presentation was associated with maternal pre-eclampsia/hypertension, preterm premature rupture of membranes, and fetal birth weight below the tenth percentile. In gestational weeks 32-36, the risks were advanced maternal age, nulliparity, previous cesarean section, preterm premature rupture of membranes, oligohydramnios, birth weight below the tenth percentile, female sex, and congenital anomaly. In term pregnancies, breech presentation was associated with advanced maternal age, nulliparity, maternal hypothyroidism, pre-gestational diabetes, placenta praevia, premature rupture of membranes, oligohydramnios, congenital anomaly, female sex, and birth weight below the tenth percentile. Conclusion Breech presentation in preterm labor is associated with obstetric risk factors compared to cephalic presentation. These risks decrease linearly with the gestational age. In moderate to late preterm delivery, breech presentation is a highrisk state and some obstetric risk factors are yet visible in early preterm delivery. Breech presentation in extremely preterm deliveries has, with the exception of preterm premature rupture of membranes, similar clinical risk profiles as in cephalic presentation.

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Section: Discussionmentioning

confidence: 99%

A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case–control study

Toijonen

Heinonen

Gissler

et al. 2019

Arch Gynecol Obstet

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“…Breech presentation (malpresentation) in the United States is the most common reason for a planned primary cesarean section [2]. This is most likely due to the association of vaginal breech delivery with an increased risk of short-term neonatal morbidity [3][4][5]. Many obstetricians and women choose a cesarean section as the mode of delivery to avoid these possible complications, even if the long-term neurological outcome of the infants is normal when mothers and fetuses are well selected, and the deliveries are handled with caution [6,7].…”

Section: Introductionmentioning

confidence: 99%

Term cesarean breech delivery in the first pregnancy is associated with an increased risk for maternal and neonatal morbidity in the subsequent delivery: a national cohort study

Macharey

Toijonen

Hinnenberg

et al. 2020

Arch Gynecol Obstet

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Purpose To determine whether there is an association between term cesarean breech delivery in the first pregnancy and maternal and neonatal morbidities in the subsequent pregnancy and delivery. Methods We conducted a retrospective, nationwide Finnish population-based cohort study, including all deliveries from January 2000 to December 2017. We included all women with the first two consecutive singleton deliveries of which the first one was a breech delivery regardless of mode of delivery (n = 11,953), and constructed a data set in which the first two deliveries for these women were connected. The outcomes of the second delivery of the women with a first pregnancy that resulted in cesarean breech delivery at term were compared with women whose first pregnancy resulted in a vaginal breech delivery at term. P-value, odds ratio, and adjusted odds ratio were calculated. Results Neonates of a subsequent delivery after cesarean breech delivery had an increased risk for arterial umbilical cord pH below seven, a higher rate of a 5 min APGAR score < 7 and a higher rate of neonatal intensive care unit admission. The women with a history of cesarean section with the fetus in breech presentation were more often in need of a blood transfusion and suffered more often a uterus rupture. In this group, the second delivery was more often a planned cesarean section, an emergency cesarean section, or an instrumental vaginal delivery. Conclusions Primary cesarean breech section in the first pregnancy is associated with adverse neonatal and maternal outcomes in the subsequent delivery.

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“…Median blood loss was more pronounced in the BCS group compared to the BTOL group. So, in breech deliveries at 3 + 0 -36 + 6 gestational weeks, BTOL did not increase neonatal morbidity compared to BCS [23,24]. Our study included 14 preterm newborns who were transferred to NICU.…”

Section: Discussionmentioning

confidence: 92%

Mode of vaginal delivery in breech presentation and perinatal outcome

2022

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Outcome of small for gestational age-fetuses in breech presentation at term according to mode of delivery: a nationwide, population-based record linkage study

Cited by 10 publications

References 24 publications

A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case–control study

A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case–control study

Term cesarean breech delivery in the first pregnancy is associated with an increased risk for maternal and neonatal morbidity in the subsequent delivery: a national cohort study

Mode of vaginal delivery in breech presentation and perinatal outcome

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