Management of breech presentation at term: a retrospective cohort study of 10 years of experience

Burgos, Jorge; Rodríguez, Laura Tesouro; Cobos, Patricia; Osuna, Carmen; Centeno, María del Mar; Larrieta, Rosa; Martínez-Astorquiza, Txantón; Fernández-Llebrez, Luis

doi:10.1038/jp.2015.75

Cited by 14 publications

(23 citation statements)

References 28 publications

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“…Burgos et al found Apgar scores below 7 at the 5 th minute in 2.9% of newborns delivered vaginally and 0.4% in elective cesarean deliveries. 12 Studies comparing planned modes of delivery, such as PREMODA, had similar results. 8 On this subject, we found that lower Apgar scores were significantly more common among neonates delivered vaginally at 1 st and 5 th minutes (Apgar score < 7 18.5% vs 5.9% and 3.1% vs 0.2%, respectively; p < 0.05).…”

Section: Discussionmentioning

confidence: 88%

“…External cephalic version is a safe procedure that can decrease the prevalence of term breech fetuses and subsequently lower the cesarean section rate. 11,12 However, the small number of women who had undergone a trial of external cephalic (circa 10% with a similar fraction on both groups) shows the low acceptance of this maneuver in the medical and pregnant population.…”

Section: Discussionmentioning

confidence: 99%

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Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

et al. 2017

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

et al. 2017

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“…Our hospital has traditionally advocated the use of vaginal delivery for breech presentation in selected cases [15]. There is no data from randomized studies that support the safety and efficacy of the induction of labor in breech presentation at term.…”

Section: Discussionmentioning

confidence: 99%

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

Burgos

Arana

Garitano

et al. 2017

Journal of Perinatal Medicine

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“…If we look at planned hospital VBB (Table 9 ), successful vaginal birth rates range from 56.7 to 71% in a sampling of single-center, multi-center, and national registry studies [ 1 , 9 , 15 , 44 – 46 ]. We attribute the high vaginal success rates in our series to the collaboration between the obstetrician and midwife and to a setting that allowed the mother to have an undisturbed, physiological labor.…”

Section: Discussionmentioning

confidence: 99%

Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births

Fischbein

Freeze

2018

BMC Pregnancy Childbirth

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BackgroundResearch on outcomes of out-of-hospital breech birth is scarce. This study evaluates the outcomes of singleton term breech and cephalic births in a home or birth center setting.MethodsThis is a retrospective observational cohort study of 60 breech and 109 cephalic planned out-of-hospital term singleton births during a 6 year period with a single obstetrician. Outcomes measured included mode of delivery; birth weights; 1 & 5-min Apgar scores; ante-, intra-, and post-partum transports; perineal integrity; and other maternal and neonatal morbidity.Results50 breech and 102 cephalic presentations were still in the obstetrician’s care at the onset of labor; of those, 10 breech and 11 cephalic mothers required transport during labor. 76% of breech and 92.2% of cephalic births were planned to occur at home, with the remainder at a freestanding birth center. When compared to the cephalic group, the breech group had a higher rate of antepartum and in-labor transfer of care and cesarean section. Among completed out-of-hospital births, the breech group had a significantly higher rate of 1-min Apgar scores < 7 but no significant difference at 5 min. Rates of vaginal birth for both groups were high, with 84% of breech and 97.1% of cephalic mothers giving birth vaginally in this series. Compared to primiparas, multiparas in both groups had less perineal trauma and higher rates of out-of-hospital birth, vaginal birth, and spontaneous vaginal birth. No breech infant or mother required postpartum hospital transport, while one cephalic infant and one cephalic mother required postpartum transport. Of the babies born out-of-hospital, there was one short-term and one longer-term birth injury among the breech group and one short-term brachial plexus injury in the cephalic group.ConclusionsA home or birth center setting leads to high rates of vaginal birth and good maternal outcomes for both breech and cephalic term singleton presentations. Out-of-hospital vaginal breech birth under specific protocol guidelines and with a skilled provider may be a reasonable choice for women wishing to avoid a cesarean section—especially when there is no option of a hospital breech birth. However, this study is underpowered to calculate uncommon adverse neonatal outcomes.

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Management of breech presentation at term: a retrospective cohort study of 10 years of experience

Abstract: Management of breech presentation with a protocol that includes ECV, careful selection criteria and active management of vaginal delivery achieve a great decrease in the rate of CS for breech presentation.

Cited by 14 publications

References 28 publications

Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

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

Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births

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