Vaginal delivery of breech presentation

Kotaska, Andrew; Menticoglou, Savas; Gagnon, Robert; Farine, Dan; Basso, Melanie; Bos, Hayley; Delisle, Marie-France; Grabowska, Kirsten; Hudon, Lynda; Mundle, William; Murphy-Kaulbeck, Lynn; Ouellet, Annie; Pressey, Tracy; Roggensack, Anne

doi:10.1016/j.ijgo.2009.07.002

Cited by 153 publications

(32 citation statements)

References 52 publications

(78 reference statements)

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“…The guidelines of the Royal College of Obstetricians and Gynaecologists and the German guidelines suggest that fetuses in breech presentation with an estimated weight ≥ 3800 g should not be delivered vaginally [8, 10]. The Canadian guidelines suggest that fetuses ≥ 4000 g should not be delivered vaginally [9]. …”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Macharey

Gissler

Ulander

et al. 2017

BMC Pregnancy Childbirth

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BackgroundVaginal breech delivery is associated with adverse perinatal outcome. The aim of this study was to identify factors associated with adverse perinatal outcome in term breech pregnancies, and to provide clinicians an aid in selecting women for a trial of vaginal labor with the fetus in breech position.MethodsWe conducted a retrospective, nationwide, Finnish population-based case-control study. All planned singleton vaginal deliveries at term with the fetus in breech position between the years 2005 and 2014 were analyzed. The study’s end point was a composite set of adverse perinatal outcomes. All infants with an adverse outcome were compared to the infants with normal outcomes. A multivariate logistic regression model was used to analyze the data.ResultsAn adverse perinatal outcome was recorded for 73 (1.5%) infants. According to the study results fetal growth restriction (adjusted odds ratio, 2.94; 95% CI, 1.30–6.67), oligohydramnios (adjusted odds ratio, 2.94; 95% CI, 1.15–7.18), a history of cesarean section (adjusted odds ratio, 2.94; 95% CI, 1.28–6.77, gestational diabetes (adjusted odds ratio, 2.89; 95% CI, 1.54–5.40), epidural anesthesia (adjusted odds ratio, 2.20; 95% CI, 1.29–3.75) and nulliparity (adjusted odds ratio, 1.84; 95% CI, 1.10–3.08) were associated with adverse perinatal outcome.ConclusionsAdverse perinatal outcome in planned vaginal breech labor at term is associated with fetal growth restriction, oligohydramnios, previous cesarean delivery, gestational diabetes, nulliparity and epidural anesthesia.

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Section: Discussionmentioning

confidence: 99%

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Macharey

Gissler

Ulander

et al. 2017

BMC Pregnancy Childbirth

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“…Breech presentation of the fetus at term is a frequent finding . Current medical consensus precludes vaginal delivery in such cases owing to an increased risk of traumatic injury and infant asphyxiation during labor, which can lead to potentially devastating long‐term sequelae or death . Although cesarean delivery is generally a safe procedure, it is not without risks and complications.…”

Section: Discussionmentioning

confidence: 99%

Success rates of early versus late initiation of external cephalic version

Lavie

Reicher

Avraham

et al. 2019

Intl J Gynecology & Obste

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Objective To determine optimum timing of external cephalic version (ECV). Methods A retrospective cohort study was conducted at a tertiary hospital in Israel between February 1, 2016, and July 1, 2017. Healthy primiparous women with breech presentation were offered either early ECV (35–36 weeks; n=54) or late ECV (37–38 weeks; n=106). Group assignment was according to the patient's preference and physician availability. The primary outcome was the rate of cephalic presentation at delivery. Secondary outcomes included rate of cesarean delivery, presentation of fetus after the first and last ECVs, and serious fetal complications. Results The incidence of undergoing more than two ECV attempts was 18.5% in the early ECV group and 5.6% in the late ECV group (P=0.039). The incidence of cephalic presentation after the first ECV was 72.2% in the early ECV group versus 66.0% in the late ECV group (P=0.048). By contrast, no statistically significant between‐group differences were found for presentation at delivery or rate of cesarean delivery. The other outcomes were also similar. Conclusion Early initiation of ECV among primiparous women increased the chance of immediate cephalic presentation; however, it had no effect on presentation at delivery or cesarean delivery rate.

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“…Recent studies of spontaneous labor resulting in the delivery of healthy newborns suggests that primigravidas frequently do not enter active labor until 6 cm and take longer to progress than previously reported. 33,34 We discuss the small but probable increase in risk to the fetus, including a 2% risk of significant short-term morbidity and 2/1000 risk of fetal death with vaginal breech delivery. We use a coping scale rather than a pain scale in physiological labor and many nonpharmacologic pain relief methods that improve both coping and maternal satisfaction.…”

mentioning

confidence: 99%

“…30 Frequent use of sedation rather than augmentation in latent phase labor also helps women to cope and prevents a cascade of interventions. 34 To qualify for a trial of labor, a woman must have adequate pelvimetry and spontaneous labor that progresses normally. 31 Management of the second stage of labor generally includes passive descent for women with regional anesthesia, as waiting for fetal descent or an urge to push helps to prevent maternal exhaustion.…”

mentioning

confidence: 99%

VBAC in the Trenches

Fineberg

Tilton

2012

Clinical Obstetrics &Amp; Gynecology

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Is vaginal birth after cesarean in the community a disappearing practice? Since 1996 the rate of trial of labor after cesarean for low-risk women has dropped precipitously. This paper reviews the current literature and summarizes opinions of community obstetricians and midwives. Descriptive data are presented to document the scope of the problem and identify barriers: liability concerns, provider biases, and institutional restrictions. Our perspective draws on experience in our community hospital with a previously high vaginal birth after cesarean rate and a subsequent ban. Strategies to reduce the skyrocketing cesarean rate and encourage trial of labor after cesarean for low-risk women are outlined.

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Vaginal delivery of breech presentation

Cited by 153 publications

References 52 publications

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study

Success rates of early versus late initiation of external cephalic version

VBAC in the Trenches

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