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Breech Delivery

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1. Mode of Term Singleton Breech Delivery

Mode of Term Singleton Breech Delivery INTERIM UPDATE ACOGCOMMITTEEOPINION Number 745 (Replaces Committee Opinion Number 340, July 2006) Committee on Obstetric Practice This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Obstetric Practice. INTERIM UPDATE: This Committee Opinion is updated as highlighted to reflect a limited, focused change in the evidence regarding external cephalic version for breech presentation at term. Additional (...) updates have been made to reflect current practice regarding vaginal breech delivery. Mode of Term Singleton Breech Delivery ABSTRACT: There is a trend in the United States to perform cesarean delivery for term singleton fetuses in a breech presentation. The number of practitioners with the skills and experience to perform vaginal breech delivery has decreased. The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider. Obstetrician

2018 American College of Obstetricians and Gynecologists

2. Expedited versus conservative approaches for vaginal delivery in breech presentation. (PubMed)

Expedited versus conservative approaches for vaginal delivery in breech presentation. In a vaginal breech birth there may be benefit from rapid delivery of the baby to prevent progressive acidosis. However, this needs to be weighed against the potential trauma of a quick delivery.The objective of this review was to assess the effects of expedited vaginal delivery (breech delivery from umbilicus to delivery of the head within one contraction) on perinatal outcomes.We searched the Cochrane (...) Pregnancy and Childbirth Group's Trials Register (31 May 2015) and reference lists of retrieved studies.Randomised trials of expedited vaginal breech delivery compared with delivery not routinely expedited in women undergoing vaginal breech delivery.Two review authors independently assessed the one identified trial for inclusion.If studies are included in future updates, two review authors will assess risk of bias, extract data and check data for accuracy.No studies were included.There is not enough

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2015 Cochrane

3. Planned caesarean section for term breech delivery. (PubMed)

Planned caesarean section for term breech delivery. Poor outcomes after breech birth might be the result of underlying conditions causing breech presentation or due to factors associated with the delivery.To assess the effects of planned caesarean section for singleton breech presentation at term on measures of pregnancy outcome.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2015).Randomised trials comparing planned caesarean section for singleton breech (...) where caesarean section is not readily available, or to methods of breech delivery that differ materially from the clinical delivery protocols used in the trials reviewed. The review will help to inform individualised decision-making regarding breech delivery. Research on strategies to improve the safety of breech delivery and to further investigate the possible association of caesarean section with infant medical problems is needed.

2015 Cochrane

4. Finding the breech: Influence of breech presentation on mode of delivery based on timing of diagnosis, attempt at external cephalic version, and provider success with version. (PubMed)

Finding the breech: Influence of breech presentation on mode of delivery based on timing of diagnosis, attempt at external cephalic version, and provider success with version. Breech presentation affects 3-4% of pregnancies at term and malpresentation is the primary indication for 10-15% of cesarean deliveries. External cephalic version is an effective intervention that can decrease the need for cesarean delivery; however, timely identification of breech presentation is required. We (...) delivery was significantly more likely (31.1% vs 12.5%; P<.01) in women with breech presentation diagnosed before 38 weeks' estimated gestational age as external cephalic version was offered, and subsequently attempted in a greater proportion of women diagnosed before 38 weeks. External cephalic version was more successful when performed by physicians with greater procedural volume during the 3.5 year period of the study (59.1% for providers performing at least 10 procedures vs 31.3% if performing

2017 Birth

5. Top 10 Most Read in May: Coffee and liver cancer risk, vaginal breech delivery and perinatal death, and the association between area deprivation and generalised anxiety disorder in women versus men.

Top 10 Most Read in May: Coffee and liver cancer risk, vaginal breech delivery and perinatal death, and the association between area deprivation and generalised anxiety disorder in women versus men. Top 10 Most Read in May: Coffee and liver cancer risk, vaginal breech delivery and perinatal death, and the association between area deprivation and generalised anxiety disorder in women versus men. | BMJ Open by 7 new entries make it into May’s top 10 most read articles. Knocking Ravnskov et al.’s (...) study off the top spot is a systematic review and meta-analysis of coffee and hepatocellular carcinoma (HCC) by Oliver Kennedy and colleagues. Their study suggests that increasing coffee consumption by two cups per day is associated with a 35% reduction in the risk of HCC. At number 3 is a national cohort study of over 520,000 term-born singletons by researchers from Norway who have found that vaginal breech delivery is associated with an excess risk for neonatal mortality compared with vaginal

2017 BMJ Open Blog

6. Breech presentation

Breech presentation Breech presentation - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Breech presentation Last reviewed: February 2019 Last updated: March 2019 Summary Refers to the baby presenting for delivery with the buttocks or feet first rather than head. Associated with increased morbidity and mortality for the mother in terms of emergency caesarean section and placenta praevia; and for the baby in terms (...) of preterm birth, small fetal size, congenital anomalies, and perinatal mortality. Incidence decreases as pregnancy progresses and by term occurs in 3% to 4% of singleton term pregnancies. Treatment options include external cephalic version to increase the likelihood of vaginal birth or a planned caesarean section, the optimal gestation being 37 and 39 weeks, respectively. Planned caesarean section is considered the safest form of delivery for infants with a persisting breech presentation at term

2018 BMJ Best Practice

7. Expedited versus conservative approaches for vaginal delivery in breech presentation. (PubMed)

Expedited versus conservative approaches for vaginal delivery in breech presentation. In a vaginal breech birth there may be benefit from rapid delivery of the baby to prevent progressive acidosis. However, this needs to be weighed against the potential trauma of a quick delivery.The objective of this review was to assess the effects of expedited vaginal delivery (breech delivery from umbilicus to delivery of the head within one contraction) on perinatal outcomes.We searched the Cochrane (...) Pregnancy and Childbirth Group's Trials Register (2 February 2012).Randomised trials of expedited vaginal breech delivery compared with delivery not routinely expedited in women undergoing vaginal breech delivery.Eligibility and trial quality were assessed by one reviewer.No studies were included.There is not enough evidence to evaluate the effects of expedited vaginal breech delivery.

2012 Cochrane

8. Editor's reply re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies' and accompanying editorial. (PubMed)

Editor's reply re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies' and accompanying editorial. 27440603 2017 04 10 2018 12 02 1471-0528 123 9 2016 08 BJOG : an international journal of obstetrics and gynaecology BJOG Editor's reply re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies (...) ' and accompanying editorial. 1563-4 10.1111/1471-0528.14023 Chien Patrick P Ninewells Hospital, Dundee, UK. eng Letter Comment England BJOG 100935741 1470-0328 AIM IM BJOG. 2016 Jan;123(1):49-57 26234485 Cesarean Section Delivery, Obstetric Female Humans Pregnancy Term Birth 2016 02 13 2016 7 22 6 0 2016 7 22 6 0 2017 4 11 6 0 ppublish 27440603 10.1111/1471-0528.14023

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2016 BJOG : an international journal of obstetrics and gynaecology

9. Re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies' and accompanying editorial. (PubMed)

Re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies' and accompanying editorial. 27440604 2017 04 10 2018 12 02 1471-0528 123 9 2016 08 BJOG : an international journal of obstetrics and gynaecology BJOG Re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies' and accompanying editorial. 1563 10.1111 (...) /1471-0528.14021 Ayuk Paul P Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK. eng Letter Comment England BJOG 100935741 1470-0328 AIM IM BJOG. 2016 Jan;123(1):49-57 26234485 Cesarean Section Delivery, Obstetric Female Humans Pregnancy Term Birth 2016 02 08 2016 7 22 6 0 2016 7 22 6 0 2017 4 11 6 0 ppublish 27440604 10.1111/1471-0528.14021

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2016 BJOG : an international journal of obstetrics and gynaecology

10. Re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. (PubMed)

Re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. 27440605 2017 04 10 2018 12 02 1471-0528 123 9 2016 08 BJOG : an international journal of obstetrics and gynaecology BJOG Re: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. 1564-5 10.1111/1471-0528.14022 Sholapurkar Shashikant L SL Department (...) of Obstetrics & Gynaecology, Royal United Hospital, Bath, UK. eng Letter Comment England BJOG 100935741 1470-0328 AIM IM BJOG. 2016 Jan;123(1):49-57 26234485 Acta Obstet Gynecol Scand. 2014 Sep;93(9):888-96 25113411 Cesarean Section Delivery, Obstetric Female Humans Pregnancy Term Birth 2016 02 08 2016 7 22 6 0 2016 7 22 6 0 2017 4 11 6 0 ppublish 27440605 10.1111/1471-0528.14022

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2016 BJOG : an international journal of obstetrics and gynaecology

12. ACOG Committee Opinion No. 745 Summary: Mode of Term Singleton Breech Delivery. (PubMed)

ACOG Committee Opinion No. 745 Summary: Mode of Term Singleton Breech Delivery. There is a trend in the United States to perform cesarean delivery for term singleton fetuses in a breech presentation. The number of practitioners with the skills and experience to perform vaginal breech delivery has decreased. The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider. Obstetrician-gynecologists and other obstetric care providers (...) should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, desires a planned vaginal delivery of a vertex-presenting fetus, and has no contraindications. External cephalic version should be attempted only in settings in which cesarean delivery services are readily available. Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for eligibility and labor management

2018 Obstetrics and Gynecology

13. ACOG Committee Opinion No. 745: Mode of Term Singleton Breech Delivery. (PubMed)

ACOG Committee Opinion No. 745: Mode of Term Singleton Breech Delivery. There is a trend in the United States to perform cesarean delivery for term singleton fetuses in a breech presentation. The number of practitioners with the skills and experience to perform vaginal breech delivery has decreased. The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider. Obstetrician-gynecologists and other obstetric care providers should offer (...) external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, desires a planned vaginal delivery of a vertex-presenting fetus, and has no contraindications. External cephalic version should be attempted only in settings in which cesarean delivery services are readily available. Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for eligibility and labor management. If a vaginal

2018 Obstetrics and Gynecology

14. Corrigendum to “Prevalence and Perinatal Outcomes of Singleton Term Breech Delivery in Wolisso Hospital, Oromia Region, Southern Ethiopia: A Cross-Sectional Study” (PubMed)

Corrigendum to “Prevalence and Perinatal Outcomes of Singleton Term Breech Delivery in Wolisso Hospital, Oromia Region, Southern Ethiopia: A Cross-Sectional Study” [This corrects the article DOI: 10.1155/2017/9413717.].

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2018 Journal of environmental and public health

15. Choose preterm breech delivery mode individually, case by case. (PubMed)

Choose preterm breech delivery mode individually, case by case. 30276950 2019 03 05 2019 03 05 1471-0528 126 1 2019 01 BJOG : an international journal of obstetrics and gynaecology BJOG Choose preterm breech delivery mode individually, case by case. 82 10.1111/1471-0528.15483 Steer P J PJ Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, Imperial College London, London, UK. eng Journal Article Comment 2018 10 24 England BJOG 100935741 1470-0328 AIM IM BJOG (...) . 2019 Jan;126(1):73-82 30216654 Breech Presentation Cohort Studies Delivery, Obstetric Humans Infant, Newborn 2018 10 3 6 0 2019 3 6 6 0 2018 10 3 6 0 ppublish 30276950 10.1111/1471-0528.15483

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2018 BJOG

16. Planned delivery route of preterm breech singletons and neonatal and 2-year outcomes: a population-based cohort study. (PubMed)

Planned delivery route of preterm breech singletons and neonatal and 2-year outcomes: a population-based cohort study. To assess whether planned route of delivery is associated with perinatal and 2-year outcomes for preterm breech singletons.Prospective nationwide population-based EPIPAGE-2 cohort study.France, 2011.Three hundred and ninety women with breech singletons born at 26-34 weeks of gestation after preterm labour or preterm prelabour rupture of membranes.Propensity-score (...) between planned caesarean delivery and improved outcomes for preterm breech singletons born at 26-34 weeks of gestation after preterm labour or preterm prelabour rupture of membranes was found. The route of delivery should be discussed with women, balancing neonatal outcomes with the higher risks of maternal morbidity associated with caesarean section performed at low gestational age.© 2018 Royal College of Obstetricians and Gynaecologists.

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2018 BJOG

17. Maternal outcomes of term breech presentation delivery: impact of successful external cephalic version in a nationwide sample of delivery admissions in the United States. (PubMed)

Maternal outcomes of term breech presentation delivery: impact of successful external cephalic version in a nationwide sample of delivery admissions in the United States. We aimed to define the frequency and predictors of successful external cephalic version in a nationally-representative cohort of women with breech presentations and to compare maternal outcomes associated with successful external cephalic version versus persistent breech presentation.Using the Nationwide Inpatient Sample (...) , a United States healthcare utilization database, we identified delivery admissions between 1998 and 2011 for women who had successful external cephalic version or persistent breech presentation (including unsuccessful or no external cephalic version attempt) at term. Multivariable logistic regression identified patient and hospital-level factors associated with successful external cephalic version. Maternal outcomes were compared between women who had successful external cephalic version versus

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2016 BMC Pregnancy and Childbirth

18. Maternal and neonatal outcomes of vaginal breech delivery for singleton term pregnancies in a carefully selected Cameroonian population: a cohort study. (PubMed)

Maternal and neonatal outcomes of vaginal breech delivery for singleton term pregnancies in a carefully selected Cameroonian population: a cohort study. Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. Very few studies on the subject have been carried out in poor-resource settings. The aim of this study was to determine maternal and neonatal outcomes in carefully selected cases of VBD for singleton term pregnancies in a tertiary centre (...) in Cameroon.A retrospective cohort study.A tertiary hospital in Yaounde, Cameroon.Cases of VBD of newborns weighing 2500-3500 g were matched in a ratio of 1:4 to consecutive vaginal cephalic deliveries (VCDs) of newborns weighing 2500-3500 g over a 5-year period. Both groups were matched for maternal age and parity. We excluded cases of multiple gestations, footling breech, clinically inadequate maternal pelvis, preterm delivery, post-term pregnancies, fetal demise prior to the onset of labour, placenta

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2017 BMJ open

19. Is vaginal breech delivery associated with higher risk for perinatal death and cerebral palsy compared with vaginal cephalic birth? Registry-based cohort study in Norway. (PubMed)

Is vaginal breech delivery associated with higher risk for perinatal death and cerebral palsy compared with vaginal cephalic birth? Registry-based cohort study in Norway. This paper aims to study if vaginal breech delivery is associated with increased risk for neonatal mortality (NNM) or cerebral palsy (CP) in Norway where vaginal delivery accounts for 1/3 of all breech deliveries.Cohort study using information from the national Medical BirthRegister and Cerebral Palsy Register.Births in Norway (...) 1999-2009.520 047 term-born singletons without congenital malformations.NNM, CP and a composite outcome of these and death during birth.Compared with cephalic births, breech births had substantially increased risk for NNM but not for CP. Vaginal delivery was planned for 7917 of 16 700 fetuses in breech, while 5561 actually delivered vaginally. Among these, NNM was 0.9 per 1000 compared with 0.3 per 1000 in vaginal cephalic delivery, and 0.8 per 1000 in those actually born by caesarean delivery (CD

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2017 BMJ open

20. Long Bone Fractures Associated with Abdominal Breech Deliveries: A Report of Two Cases. (PubMed)

Long Bone Fractures Associated with Abdominal Breech Deliveries: A Report of Two Cases. BACKGROUND: Birth-related injuries are a well-known complication of vaginal breech deliveries but are not anticipated during cesarean breech deliveries. However, long bone fractures in the neonate can result from delivery of the breech presentation by cesarean section. CASES: We report 2 cases of long bone fractures that occurred during cesarean section for breech presentation. No underlying bone pathology (...) or systemic illness could be identified in either case. There were no other predisposing risk factors for fractures except breech presentation. Both infants were managed with cast application and outpatient physical therapy and recovered without any residual deformity. CONCLUSION: Obstetricians should be aware of the possibility of long bone fractures with abdominal breech deliveries. Their prompt recognition and conservative management, including physical therapy, can prevent bone deformities.

2017 Journal of Reproductive Medicine

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