Too late to back out? Options for breech presentation management

Sharoni, Limor; Lyell, Deirdre J.; Weiniger, Carolyn F.

doi:10.1136/jech-2015-205528

Cited by 3 publications

(7 citation statements)

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“…Data on the percentage of women with breech babies who seek planned vaginal birth is limited, however in Australia, 2013 data shows that of the 13, 617 babies who were diagnosed breech at term (4.4% of all babies born), 88% were delivered by CS 3 . This trend is echoed across a number of developed countries [4][5][6] . The small number of vaginal breech births (VBBs) can most likely be attributed to a large international randomised control trial conducted in 2000, known as the Term Breech Trial, which concluded that planned CS is the safest mode of birth for babies in the breech position 7 .…”

Section: What This Paper Addsmentioning

confidence: 96%

The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth

2017

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Women search online for information about vaginal breech birth in an attempt to come to a place in their decision-making where they feel comfortable with their birth plan. This study highlights the need for clinicians to provide comprehensive, unbiased information on the risks and benefits of all options for breech birth to facilitate informed decision-making for the woman. This will contribute to improving the woman's confidence in distinguishing between "the fact and the fiction" of breech birth discussions online.

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Section: What This Paper Addsmentioning

confidence: 96%

The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth

2017

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“…The American College of Obstetricians and Gynecologists notes the decreasing number of practitioners with the skills and experience to perform vaginal breech delivery 24 . Obstetrical skills to manage vaginal breech delivery should be as widespread as breech presentation 25 . Suboptimal antenatal care and/or management of in‐hospital deliveries is more common in deliveries with intrapartum or neonatal death than in deliveries where the offspring survives 26 …”

Section: Discussionmentioning

confidence: 99%

“…24 Obstetrical skills to manage vaginal breech delivery should be as widespread as breech presentation. 25…”

Section: Discussionmentioning

confidence: 99%

“…24 Obstetrical skills to manage vaginal breech delivery should be as widespread as breech presentation. 25 Suboptimal antenatal care and/or management of in-hospital deliveries is more common in deliveries with intrapartum or neonatal death than in deliveries where the offspring survives. 26 Multiple methods have been tried in the search for improved birth outcomes for breechpresenting fetuses.…”

Section: National Guidelines Have Different Recommendations For Iol In Breech Deliveries Thementioning

confidence: 99%

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Induction of labor in breech presentations ‐ a retrospective cohort study

Welle-Strand

Tappert

Eggebø

2021

Acta Obstet Gynecol Scand

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Introduction: There is limited evidence on the safety and outcome of induction of breech labor.In this study, we aimed to compare the outcomes of spontaneous and induced breech deliveries and to describe variations in induction rates. Material and methods:This was a retrospective cohort study comprising 1054 singleton live fetuses in breech presentation at Trondheim University Hospital from 2012 to 2019. The main outcome was intrapartum cesarean section, and secondary outcomes were postpartum hemorrhage, anal sphincter ruptures, Apgar scores, pH in the umbilical artery and metabolic acidosis. All data were obtained from the hospital birth journal.Results: Induction of labor was performed in 127/606 (21.0%) of women with planned vaginal birth. The frequency of intrapartum cesarean section was 48.0% for induced labor vs 45.7% for spontaneous labor (p=0.64). We found no differences in the frequency of postpartum hemorrhage or anal sphincter ruptures between induced and spontaneous births. The median pH in the umbilical artery was significantly lower in neonates with induced labor compared with neonates with spontaneous labor (7.22 vs 7.25; p=0.02). The frequency of pH <7.05 was 7.0% for induced labor vs 2.9% (p= 0.05) for spontaneous labor, but the frequency of pH <7.0 was not significantly different: 2.6% vs 0.8% (p=0.14), respectively. Three neonates with planned vaginal birth had metabolic acidosis: two with spontaneous labors and one with induced labor. Three fetuses with planned vaginal birth died during labor: two with spontaneous onset of labor and one with induced labor. All three were extremely preterm: two were delivered in week 23 and one in week 25. We did not observe any significant trend in induction rates in either parous or in nulliparous women. Conclusions:The induction rates were stable during the study period. We did not observe any significant difference in intrapartum cesarean section rates, in the frequency of pH <7.0 in the umbilical artery, or in the frequency of metabolic acidosis when comparing induced and spontaneous breech deliveries.

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“…The information shock is based on a study called the Term Breech Trial (TBT) by Hannah et al (2000). The study suggested that a planned Csection is preferred over vaginal delivery for breech births, which led to a substantial increase in planned C-sections for breech births in Sweden and in many other countries (Alexandersson et al, 2005;Sharoni et al, 2015). Thus, I exploit arguably exogenous variation in the proportion of Csection deliveries induced by the information shock in a fuzzy regression discontinuity design (Lee and Lemieux, 2010).…”

Section: Introductionmentioning

confidence: 99%

Cesarean sections for high‐risk births: health, fertility, and labor market outcomes*

Mühlrad

2022

Scandinavian J Economics

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Despite the fact that Cesarean section (C-section) is the most commonly performed surgery in a number of industrialized countries, little is known about the long-term consequences for the mothers and children involved. In this study, I use a sample of high-risk births-namely, breech births, in which the fetus is presented with its head upward instead of downward-to study the causal effect of C-sections on child health and on the health, fertility and labor market responses for mothers. Because selection into C-section may be endogenous, I exploit an information shock to doctors in 2000, in which new scientific evidence about the benefits of planned Csections for breech births led to a sharp 23% increase in planned C-sections. Using Swedish registry data, I find that having a C-section improves child health in both the short and long run, indicated by higher Apgar scores at birth and fewer nights hospitalized during ages 1-7. I find little evidence to suggest any significant impact on maternal health, future fertility or maternal labor market outcomes.

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Too late to back out? Options for breech presentation management

Cited by 3 publications

References 64 publications

The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth

The fact and the fiction: A prospective study of internet forum discussions on vaginal breech birth

Induction of labor in breech presentations ‐ a retrospective cohort study

Cesarean sections for high‐risk births: health, fertility, and labor market outcomes*

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