Factors influencing the effect of external cephalic version: a retrospective nationwide cohort analysis

Londero, Ambrogio P.; Xholli, Anjeza; Massarotti, Claudia; Fruscalzo, Arrigo; Cagnacci, Angelo

doi:10.1007/s00404-022-06763-2

Cited by 3 publications

(1 citation statement)

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“…The SEER compiles cancer incidence and survival data from cancer registries covering approximately 34.6% of the U.S. population [ 6 ]. The National Vital Statistics System collects birth data from every state and territory in the United States [ 7 ]. We compared the breast cancer age-standardized rate (ASR) in the United States and Italy using GLOBOCAN data published by the International Agency for Research on Cancer (IARC) (GLOBOCAN Cancer Observatory— https://gco.iarc.fr/ , accessed on 10th May 2023).…”

Section: Methodsmentioning

confidence: 99%

Breast cancer and the steadily increasing maternal age: are they colliding?

Londero,

Bertozzi,

Xholli

et al. 2024

BMC Women's Health

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Background Pregnancy-related cancers are mostly breast cancers, and their incidence is likely to increase as a result of the modern trend of delaying childbearing. In particular, advanced maternal age increases breast cancer risk, and younger breast cancer patients are more likely to die and metastasize. This study compared a population with a high incidence of delayed childbearing with another population with a lower mean age at childbirth in order to determine whether breast cancer diagnosis and childbearing age overlap. Methods We retrospectively analyzed multiple data sources. The Surveillance, Epidemiology, and End Results (SEER) program, the United States National Center for Health Statistics as part of the National Vital Statistics System, the United Nations Population Division, the GLOBOCAN Cancer Observatory, the CLIO-INFRA project database, the Human Fertility Database, and anonymized local data were used. Results As women’s age at delivery increased, the convergence between their age distribution at breast cancer diagnosis and childbearing increased. In addition, the overlap between the two age distributions increased by more than 200% as the average age at delivery increased from 27 to 35 years. Conclusions As women’s average childbearing age has progressively risen, pregnancy and breast cancer age distributions have significantly overlapped. This finding emphasizes the need for increased awareness and educational efforts to inform women about the potential consequences of delayed childbearing. By providing comprehensive information and support, women can make more informed decisions about their reproductive health and cancer prevention strategies.

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Section: Methodsmentioning

confidence: 99%

Breast cancer and the steadily increasing maternal age: are they colliding?

Londero,

Bertozzi,

Xholli

et al. 2024

BMC Women's Health

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Routine 36‐week scan: diagnosis and outcome of abnormal fetal presentation

Fitiri,

Papavasileiou,

Mesaric

et al. 2024

Ultrasound in Obstet & Gyne

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ObjectivesFirst, to report the incidence of non‐cephalic presentation at a routine 36‐week ultrasound scan, the uptake and success of external cephalic version (ECV) and the incidence of spontaneous rotation from non‐cephalic to cephalic presentation. Second, to determine the maternal and pregnancy characteristics that provide a significant contribution to the prediction of non‐cephalic presentation at the 36‐week scan, successful ECV from non‐cephalic to cephalic presentation and spontaneous rotation from non‐cephalic to cephalic presentation.MethodsThis was a retrospective analysis of prospectively collected data from 107 875 women with a singleton pregnancy who had undergone a routine ultrasound scan at 35 + 0 to 36 + 6 weeks' gestation. Patients with breech or transverse/oblique presentation were divided into two groups: those scheduled for elective Cesarean section for a fetal or maternal indication other than abnormal presentation, and those that would potentially require ECV. The latter group was reassessed after 1–2 weeks and, if the abnormal presentation persisted, the parents were offered ECV or elective Cesarean section at 38–40 weeks' gestation. Multivariable logistic regression analysis was carried out to determine which maternal and pregnancy characteristics provided a significant contribution in the prediction of non‐cephalic presentation at the 36‐week scan, successful ECV from non‐cephalic to cephalic presentation and spontaneous rotation from non‐cephalic to cephalic presentation.ResultsAt the 36‐week scan, fetal presentation was cephalic in 101 664 (94.2%) pregnancies and either breech, transverse or oblique in 6211 (5.8%). In 0.3% of cases with cephalic presentation at the 36‐week scan, there was subsequent spontaneous rotation to non‐cephalic presentation, and in half of these, the diagnosis was made during labor or at birth. ECV was attempted in 1584/6211 (25.5%) pregnancies with non‐cephalic presentation at the 36‐week scan and was successful in only 44.1% of cases. In the remaining 74.5% of cases, ECV was not attempted because of any of the following reasons: ECV was declined; Cesarean section was planned for a reason other than abnormal presentation; ECV was planned for the subsequent 1–2 weeks but, in the meantime, there was spontaneous rotation to cephalic presentation; or there was spontaneous onset of labor or rupture of membranes before planned ECV. In 5513/6211 (88.8%) pregnancies with non‐cephalic presentation at the 36‐week scan, ECV was not attempted or was unsuccessful, and in 37.7% of these, there was subsequent spontaneous rotation to cephalic presentation. Among the 6211 pregnancies with non‐cephalic presentation at the 36‐week scan, the presentation at birth was cephalic in 43.8%; in 74.8%, this was due to spontaneous rotation, and in 25.2%, it was due to successful ECV. Multivariable analysis demonstrated that the likelihood of non‐cephalic presentation at the 36‐week scan, that of successful ECV and that of spontaneous rotation from non‐cephalic to cephalic presentation was affected by several maternal and pregnancy characteristics, but the predictive performance for these events was poor, with the area under the receiver‐operating‐characteristics curve ranging from 0.608 to 0.717 and the detection rate at a 10% false‐positive rate ranging from 19.0% to 33.7%.ConclusionsRoutine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation could improve pregnancy outcome by substantially reducing the risk of unexpected abnormal presentation in labor. However, an additional ultrasound scan for fetal presentation should be considered in all women when they present in labor. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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