Can Labor with Breech Presentation Be Induced?

Abstract

Our objective was to evaluate the efficacy and safety of labor induction in women with a breech presentation, and an unripe cervix. We conducted a retrospective, matched-paired study on patients with breech presentation and an unripe cervix (n = 23), who underwent induction of labor using extra-amniotic saline instillation. The women were compared to three matched control groups: 46 women with vertex presentation and an unripe cervix, whose labor was induced by the same method, 23 with breech presentation who underwent a vaginal trial of labor, and 23 women with breech presentation who underwent a cesarean section without a trial of labor. In the study group, 12 women (52.2%) delivered vaginally. Rates of Apgar score, birth trauma, and maternal morbidity were similar in all groups. Induction of labor in patients with a breech presentation and an unripe cervix may be attempted in selected cases as it seems to be efficacious (vaginal delivery rate of 52.2%) and safe for both fetus and mother.

Induction of labor in breech presentation at term: a retrospective cohort study

“…Our results are consistent with the limited data in the literature from observational and retrospective studies. These suggest that induction of labor in breech presentation is a reasonable option, with similar outcomes of spontaneous onset of labor in breech presentation, provided a pregnancy with breech presentation was carefully selected and delivery was carried out in a center with an appropriate protocol and experienced assistance of planed vaginal breech delivery [16][17][18][19].…”

Induction of labor in breech presentations at term: a retrospective observational study

“…These studies had small number of women (N = 13-53) and reported quite similar vaginal delivery rates ranging from 50 to 66 %. The induction groups in these studies were compared to spontaneous breech deliveries, cephalic deliveries or planned cesarean sections in breech position [20][21][22].…”

“…In contrast, induction of labor in breech presentation is a bit controversial and rarely practiced. Only few studies with small sample sizes (N = 13-53) have been published in the English literature [20][21][22]. These studies, albeit few have shown favorable maternal and neonatal outcomes in breech delivery inductions at term.…”

Induction du travail et présentation du siège : expérience de la maternité de l’hôpital Robert-Debré, Paris

“…Si l'on compare ce taux à celui des patientes ayant eu une césarienne avant travail pour échec de déclenchement avec un foetus en présentation céphalique, il existe une différence significative, comme indiqué dans le Tableau 4 ci-dessous. (4,9) p < 0,01 RCIU, n (%) 6 (1,2) 6 (4,9) p < 0,01 Autres motifs, n (%) 52 (10,4) 22 (17,9) La maturation cervicale dans les présentations du siège est un sujet controversé, tout comme l'a été son mode d'accouchement depuis l'étude d'Hannah [8], mais très peu d'études ont traité la question de la maturation cervicale et du déclenchement du travail dans ces présentations.…”

“…Une étude suisse [17] a comparé rétrospectivement 23 patientes avec des conditions locales défavorables et un foetus en siège dont le travail était induit par amnio-infusion à trois autres groupes : un groupe similaire mais avec une présentation céphalique, un groupe de foetus en présenta-tion du siège avec tentative de voie basse et un troisième groupe de césarienne systématique sur présentation du siège. Les Apgar inférieurs à sept à cinq minutes, les traumatismes néonataux, ainsi que la morbidité maternelle étaient similaires dans les quatre groupes.…”