OBJECTIVES: To assess the safety of a decision protocol for type of delivery of breech presentations after 37 weeks of gestation. This protocol was based on a comparison of fetal head and maternal pelvic measurements. STUDY DESIGN: Retrospective before-and-after study of 1133 breech infants born between 2000 and 2008 in a tertiary centre, analysing neonatal condition and percentage of vaginal deliveries by study period. RESULTS: Application of the protocol was accompanied by an increase in the percentage of vaginal deliveries of breech presentations from 24.0% in 2000-2004 to 38.5% in 2004-2008 (p<0.001), without impairment of neonatal condition [composite mortality/morbidity variable: 3/567 (0.5%) vs 4/566 (0.7%), respectively; p>0.99; neonatal arterial pH<7.0: 8/521 (1.5%) vs 4/529 (0.8%), respectively; p=0.23]. CONCLUSION: The use of a protocol based on objective criteria at the authors' centre made it possible to increase the percentage of vaginal deliveries of breech presentations without impairing neonatal condition.
OBJECTIVES: To assess the safety of a decision protocol for type of delivery of breech presentations after 37 weeks of gestation. This protocol was based on a comparison of fetal head and maternal pelvic measurements. STUDY DESIGN: Retrospective before-and-after study of 1133 breech infants born between 2000 and 2008 in a tertiary centre, analysing neonatal condition and percentage of vaginal deliveries by study period. RESULTS: Application of the protocol was accompanied by an increase in the percentage of vaginal deliveries of breech presentations from 24.0% in 2000-2004 to 38.5% in 2004-2008 (p<0.001), without impairment of neonatal condition [composite mortality/morbidity variable: 3/567 (0.5%) vs 4/566 (0.7%), respectively; p>0.99; neonatal arterial pH<7.0: 8/521 (1.5%) vs 4/529 (0.8%), respectively; p=0.23]. CONCLUSION: The use of a protocol based on objective criteria at the authors' centre made it possible to increase the percentage of vaginal deliveries of breech presentations without impairing neonatal condition.
Authors: Constantin S von Kaisenberg; Delnaz Fard; Chiara S Borchers; Jill-Caren Philippeit; Anja V Philippeit; Laura R Kaukemüller; Lara R Higgins-Wood; Spyridon Papageorgiou; Peter Hillemanns; Rüdiger Klapdor Journal: Arch Gynecol Obstet Date: 2022-07-20 Impact factor: 2.493
Authors: S Derisbourg; E Costa; L De Luca; S Amirgholami; V Bogne Kamdem; A Vercoutere; W H Zhang; S Alexander; P M Buekens; Y Englert; A Pintiaux; C Daelemans Journal: BMC Pregnancy Childbirth Date: 2020-07-29 Impact factor: 3.007