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

Abstract

The vaginal delivery rate was significantly lower in induced than in spontaneous breech deliveries. The neonatal and maternal morbidity and mortality rates were similar implying that induction in breech delivery is an option and it is time for clinical reappraisal.

Is induction of labor a reasonable option for breech presentation?

“…No differences between the three groups were identified, but the only morbidity outcome was the 5‐minute Apgar score . The few other retrospective studies comparing IOL to spontaneous onset of labor are reassuring in terms of infant safety with variable outcomes . To compare the groups, Burgos et al.…”

“…In 2006, a French assessment of practices revealed that IOL for breech presentation was used frequently by 12.5% of obstetric teams, occasionally by 59.7% and never by 27.8% . Only a few studies evaluated labor induction of breech presentation and their results in terms of safety are reassuring . These studies compared women with induced labor with women with spontaneous labor.…”

State of the breech in 2020: Guidelines support maternal choice, but skills are lost….

“…Given the small number of providers who are experienced and supportive of the option of planned vaginal breech, the option of labor induction may increase access. Although there have been concerns with respect to the safety of breech induction and the potential to increase the likelihood of cesarean, the results of four retrospective studies comprising 608 induced vaginal breech deliveries did not demonstrate increased perinatal morbidity in any of the studies . The risk of cesarean was not increased in three of the four studies .…”

“…Although there have been concerns with respect to the safety of breech induction and the potential to increase the likelihood of cesarean, the results of four retrospective studies comprising 608 induced vaginal breech deliveries did not demonstrate increased perinatal morbidity in any of the studies . The risk of cesarean was not increased in three of the four studies . Based on these studies, the 2019 SOGC recommendations state that induction of labor does not appear to be associated with poorer outcomes, although evidence is limited based on study size .…”

Breech presentation at term and associated obstetric risks factors—a nationwide population based cohort study

“…The impact of the term breech trial has, however, been questioned as the stringent criteria for vaginal breech delivery were violated in many ways and many of the stillbirths occurred in growth restricted pregnancies [5]. Since then, a number of studies have been published showing that vaginal breech delivery is safe for mother and child if the women are carefully selected for a trial of labor and labor management takes place in an appropriate obstetric setting [6][7][8][9][10][11][12]. In the…”