Term breech deliveries in the Netherlands: did the increased cesarean rate affect neonatal outcome? A population‐based cohort study

Vlemmix, Floortje; Bergenhenegouwen, Lester; Schaaf, Jelle M.; Ensing, Sabine; Rosman, Ageeth N.; Ravelli, Anita C.J.; Post, Joris A. M. van der; Verhoeven, A.T.M.; Visser, Gerard H.A.; Mol, Ben Willem J.; Kok, Marjolein

doi:10.1111/aogs.12449

Cited by 104 publications

(105 citation statements)

References 24 publications

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“…The same correlation was also observed in a Dutch study [35]. Both the French and the Dutch studies registered a slight decrease in the rate of C-sections for breech presentation after 2005 [34,35]. 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].…”

Section: Risk Factors For C-sectionsupporting

confidence: 70%

“…A study of French perinatal data (from 1994 to 2010) showed a significant increase in C-section rates for breech presentation following the publication of that study [34]. The same correlation was also observed in a Dutch study [35]. Both the French and the Dutch studies registered a slight decrease in the rate of C-sections for breech presentation after 2005 [34,35].…”

Section: Risk Factors For C-sectionmentioning

confidence: 61%

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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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Section: Risk Factors For C-sectionsupporting

confidence: 70%

Section: Risk Factors For C-sectionmentioning

confidence: 61%

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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“…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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“…Our success rate for attempted vaginal birth was 57.5%, somewhat lower than that in the PREMODA study (71%) and similar to that in the Dutch cohort (≈50%). 10,21 A vaginal breech delivery entails short-term fetal distress and this is reflected in the early perinatal parameters. Indeed, the overall results at this stage are better for PCS than for PVD.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, as in other published series, more than 97% of infants from PVDs progressed well without the need for extra neonatal care. 10,21 We had one case of intrapartum death, the baby dying in the birth canal secondary to complications during assisted vaginal delivery, producing a mortality rate of 1.1‰ (1/891) in the PVD group. This rate is lower than in the overall results presented in the Term Breech Trial (12.5‰ (13/1039)) and in the subgroup of countries with low perinatal mortality rates (5.8‰ (3/511)), 1 vaginal breech deliveries (0.8‰ (2/2502) 10 and 1.6‰ (30/18 388) 21 ).…”

Section: Discussionmentioning

confidence: 99%

Management of breech presentation at term: a retrospective cohort study of 10 years of experience

et al. 2015

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Term breech deliveries in the Netherlands: did the increased cesarean rate affect neonatal outcome? A population‐based cohort study

Cited by 104 publications

References 24 publications

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

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

Singleton Vaginal Breech Delivery at Term: Maternal and Perinatal Outcome

Management of breech presentation at term: a retrospective cohort study of 10 years of experience

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