Induction of labor at term following external cephalic version in nulliparous women is associated with an increased risk of cesarean delivery

Hants, Yael; Kabiri, Doron; Elchalal, Uriel; Arbel-Alon, Sagit; Drukker, Lior; Ezra, Yossef

doi:10.1007/s00404-015-3643-z

Cited by 15 publications

(6 citation statements)

References 44 publications

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“…The vaginal delivery rate after induction in breech position is comparable to the vaginal delivery rate for induced deliveries with the fetus in cephalic presentation as shown by a Cochrane review by Liu with a vaginal delivery rate of 73-74 % [18]. It is also comparable with the vaginal delivery rates of 79.7 % after successful cephalic version and induction of labor [26]. Induction of delivery with the fetus in vertex position is common practice [18], while induction in breech presentation is controversial [14][15][16][17].…”

Section: Discussionsupporting

confidence: 66%

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

Macharey

Ulander

Heinonen

et al. 2015

Arch Gynecol Obstet

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Section: Discussionsupporting

confidence: 66%

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

Macharey

Ulander

Heinonen

et al. 2015

Arch Gynecol Obstet

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“…In a matched cohort study, it has demonstrated that vaginal delivery rate was lower in women with labor induction when compared with spontaneous labor . Induction of labor was correlated with a lower vaginal delivery rate since it would increase the risk of cesarean section …”

Section: Discussionmentioning

confidence: 99%

Use of labor induction with dinoprostone vaginal suppositories in pregnant women with gestational hypertension

Zhou

et al. 2019

J of Obstet and Gynaecol

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Aim: Gestational hypertension is a common disorder of pregnancy. This study aims to evaluate the effect of labor induction with dinoprostone vaginal suppositories (Propess) on pregnancy outcomes in pregnant women with gestational hypertension. Methods: The retrospective study included 375 patients with gestational hypertension. All patients were included into three groups according to the characteristics at admission. Women who had initiated labor spontaneously at admission were enrolled in Spontaneous labor group. According to Bishop score, other patients underwent labor induction with Propess or oxytocin were enrolled in Propess group or Oxytocin group. Demographic information and perinatal outcome data were collected. Results: The vaginal delivery rate of the women with gestational hypertension was respectively 93.5% (Spontaneous labor group), 77.0% (Propess group), and 52.5% (Oxytocin group) in three groups with significant difference (P < 0.001). The duration of labor was 8.29 AE 3.70 h (Spontaneous labor group), 8.45 AE 5.21 h (Propess group) and 12.37 AE 11.47 h (Oxytocin group) in three groups, respectively. No differences were found in the intrapartum fever (P = 0.588), intrapartum hemorrhage (P = 0.953), intrapartum maximum blood pressure (P = 0.301 and P = 0.535) and post-partum hemorrhage (P = 0.075) among three groups. Neonatal outcomes were similar among three groups (Neonatal hospitalization rate, P = 0.437; 1-min Apgar score, P = 0.304; 5-min Apgar score, P = 0.340; Birth weight, P = 0.089). No poor maternal and neonatal outcomes occurred. Conclusion: Pregnant women with gestational hypertension could have favorable pregnancy outcomes. Using Propess as a mode of labor induction in gestational hypertension is safe and effective, without increasing intrapartum blood pressure and inducing poor pregnancy outcomes.*P < 0.05 comparison between Spontaneous labor group and Oxytocin group.; **P < 0.05 comparison between Spontaneous labor group and Propess group.; ***P < 0.05 comparison between Oxytocin group and Propess group.; P value, comparison between three group by One-way analysis of variance. and DBP, diastolic blood pressure; SBP, systolic blood pressure.

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“…If ECV was successful, a reversion back to breech presentation was possible. It is currently unclear whether the probability of MOD varies depending on whether cephalic presentation is the result of successful ECV or spontaneous reversion [2,10,29–31], but we assumed that the probabilities differed.…”

Section: Methodsmentioning

confidence: 99%

Screening for breech presentation using universal late-pregnancy ultrasonography: A prospective cohort study and cost effectiveness analysis

et al. 2019

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Background Despite the relative ease with which breech presentation can be identified through ultrasound screening, the assessment of foetal presentation at term is often based on clinical examination only. Due to limitations in this approach, many women present in labour with an undiagnosed breech presentation, with increased risk of foetal morbidity and mortality. This study sought to determine the cost effectiveness of universal ultrasound scanning for breech presentation near term (36 weeks of gestational age [wkGA]) in nulliparous women. Methods and findings The Pregnancy Outcome Prediction (POP) study was a prospective cohort study between January 14, 2008 and July 31, 2012, including 3,879 nulliparous women who attended for a research screening ultrasound examination at 36 wkGA. Foetal presentation was assessed and compared for the groups with and without a clinically indicated ultrasound. Where breech presentation was detected, an external cephalic version (ECV) was routinely offered. If the ECV was unsuccessful or not performed, the women were offered either planned cesarean section at 39 weeks or attempted vaginal breech delivery. To compare the likelihood of different mode of deliveries and associated long-term health outcomes for universal ultrasound to current practice, a probabilistic economic simulation model was constructed. Parameter values were obtained from the POP study, and costs were mainly obtained from the English National Health Service (NHS). One hundred seventy-nine out of 3,879 women (4.6%) were diagnosed with breech presentation at 36 weeks. For most women (96), there had been no prior suspicion of noncephalic presentation. ECV was attempted for 84 (46.9%) women and was successful in 12 (success rate: 14.3%). Overall, 19 of the 179 women delivered vaginally (10.6%), 110 delivered by elective cesarean section (ELCS) (61.5%) and 50 delivered by emergency cesarean section (EMCS) (27.9%). There were no women with undiagnosed breech presentation in labour in the entire cohort. On average, 40 scans were needed per detection of a previously undiagnosed breech presentation. The economic analysis indicated that, compared to current practice, universal late-pregnancy ultrasound would identify around 14,826 otherwise undiagnosed breech presentations across England annually. It would also reduce EMCS and vaginal breech deliveries by 0.7 and 1.0 percentage points, respectively: around 4,196 and 6,061 deliveries across England annually. Universal ultrasound would also prevent 7.89 neonatal mortalities annually. The strategy would be cost effective if foetal presentation could be assessed for £19.80 or less per woman. Limitations to this study included that foetal presentation was revealed to all women and that the health economic analysis may be altered by parity. Conclusions According to our estimates, universal late pregnancy ultrasound in nulliparous women (1) would virtually eliminate undiagnosed breech presentation, (...

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Induction of labor at term following external cephalic version in nulliparous women is associated with an increased risk of cesarean delivery

Abstract: Induction of labor after successful ECV in nulliparous women increased the risk of CD compared with IOL with spontaneous cephalic presentation.

Cited by 15 publications

References 44 publications

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

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

Use of labor induction with dinoprostone vaginal suppositories in pregnant women with gestational hypertension

Screening for breech presentation using universal late-pregnancy ultrasonography: A prospective cohort study and cost effectiveness analysis

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