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Breech Delivery

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21. 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. Full Text available with Trip Pro

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

2017 BMJ open

22. Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births. Full Text available with Trip Pro

Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births. Research 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.This 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.50 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

2018 BMC Pregnancy and Childbirth

23. Breech Delivery

Breech Delivery Breech Delivery Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Breech Delivery Breech Delivery Aka: Breech Delivery (...) forceps Empty with catheterization Deliver the first leg and then the second Grasping both legs, deliver body to level of With the baby's buttock's up, deliver baby to the level of their chest Rotate the baby 90 degrees and swep out one arm Rotate the baby 180 degrees and sweep out the other arm Deliver the s With your finger in the baby's mouth, pull down to deliver the head Avoids neck Consider applying suprapubic pressure VI. Complications of Breech Delivery: Maternal Fourth degree perineal tear

2018 FP Notebook

24. 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

25. Maternal outcomes of term breech presentation delivery: impact of successful external cephalic version in a nationwide sample of delivery admissions in the United States. Full Text available with Trip Pro

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

2016 BMC Pregnancy and Childbirth

26. Once more unto the breech: planned vaginal delivery compared with planned cesarean delivery. (Abstract)

Once more unto the breech: planned vaginal delivery compared with planned cesarean delivery. This article provides a knowledge-based assessment of planned cesarean delivery compared with planned vaginal delivery for breech presentation at term gestation. The most critical evidence on this issue is the intention-to-treat analysis from the Term Breech Trial, which showed that planned cesarean delivery reduced composite perinatal death and serious neonatal morbidity. Although (...) delivery group; lack of exclusion criteria led to higher risk women (with contraindications to vaginal delivery) being included in the planned cesarean delivery group. Such selection bias notwithstanding, both the Term Breech Trial and the PREMODA study showed significantly higher rates of 5-minute Apgar score less than 4, 5-minute Apgar score less than 7, intubation, and birth trauma in the planned vaginal delivery group. Finally, studies from the Netherlands, Denmark, and Canada have shown

2015 Obstetrics and Gynecology

27. Morbidity and mortality associated with mode of delivery for breech periviable deliveries. Full Text available with Trip Pro

Morbidity and mortality associated with mode of delivery for breech periviable deliveries. The purpose of this study was to estimate the odds of morbidity and death that are associated with cesarean delivery, compared with vaginal delivery, for breech fetuses who are delivered from 23-24 6/7 weeks' gestational age.We conducted a retrospective cohort study of state-level maternal and infant hospital discharge data that were linked to vital statistics for breech deliveries that occurred from 23 (...) -24 6/7 weeks' gestation in California, Missouri, and Pennsylvania from 2000-2009 (N = 1854). Analyses were stratified by gestational age (23-23 6/7 vs 24-24 6/7 weeks' gestation).Cesarean delivery was performed for 46% (335 fetuses) and 77% (856 fetuses) of 23- and 24-week breech fetuses. In multivariable analyses, overall survival was greater for cesarean-born neonates (adjusted odds ratio [AOR], 3.98; 95% confidence interval [CI], 2.24-7.06; AOR, 2.91; 95% CI, 1.76-4.81, respectively). When

2015 American Journal of Obstetrics and Gynecology

28. Maternal and neonatal outcome of reverse breech extraction of an impacted fetal head during caesarean section in advanced stage of labour: a retrospective cohort study. Full Text available with Trip Pro

. No statistically significant differences for the neonatal outcomes were described so far. However, among the group of difficult fetal delivery with the head pushing method two neonates had perinatal skull fractures, with one of those resulting in neonatal death.The head pushing method is associated with higher maternal morbidity than the reverse breech method for extraction of a deeply engaged fetus during intrapartum caesarean section in advanced stage of labour. (...) Maternal and neonatal outcome of reverse breech extraction of an impacted fetal head during caesarean section in advanced stage of labour: a retrospective cohort study. Caesarean section with extraction of a deeply impacted fetal head is technically challenging and is associated with serious maternal and neonatal complications. The purpose of the study was to identify risks and evaluate selected outcome parameters associated with difficult fetal head extraction during caesarean section

2019 BMC Pregnancy and Childbirth

29. Breech presentation is associated with lower adolescent tibial bone strength. (Abstract)

- 0.29 to 0.00), CSA (- 0.12SD, - 0.26 to 0.02), BMD (- 0.16SD, - 0.31 to - 0.01), periosteal circumference (- 0.14SD, - 0.27 to - 0.01), and CSMI (- 0.11SD, - 0.24 to 0.01). In females only, breech presentation was associated with lower hip CSA (- 0.24SD, - 0.43 to 0.00) but not with other hip outcomes. Additional adjustment for potential mediators (delivery method, birthweight, gestational age, childhood motor competence and adolescent height and body composition) did not substantially affect (...) Breech presentation is associated with lower adolescent tibial bone strength. We compared bone outcomes in adolescents with breech and cephalic presentation. Tibia bone mineral content, density, periosteal circumference, and cross-sectional moment of inertia were lower in breech presentation, and females with breech presentation had lower hip CSA. These findings suggest that prenatal loading may exert long-lasting influences on skeletal development.Breech position during pregnancy is associated

2019 Osteoporosis International

30. Turning Foetal Breech Presentation at 32-35 Weeks of Gestational Age by Acupuncture and Moxibustion. Full Text available with Trip Pro

a day for two weeks and if foetuses still were in breech presentation, moxibustion, and needle in the points BL65 and SI1, lasting 30 minutes, for three days in one week. The main outcome was vaginal birth with vertex presentation at delivery; the secondary outcome was compliance in the self-administration of the moxibustion treatment.We observed cephalic version and natural childbirth in 62.4% of all treated women. The treatment was accepted by 98.9% women (93/94), and compliance was 91.4% (85/93 (...) Turning Foetal Breech Presentation at 32-35 Weeks of Gestational Age by Acupuncture and Moxibustion. Foetal breech presentation is an obstetric problem that often leads to caesarean section. Stimulation of the acupoint BL67 by moxibustion may correct breech presentation.We observed 93 pregnant women in the 32nd-35th week of gestation with normal pregnancy and ultrasound diagnosis of breech presentation. The patients received stimulation of acupoint BL67 by self-administered moxibustion once

2019 Evidence-based Complementary and Alternative Medicine (eCAM)

31. Evaluation of the effectiveness of transcutaneous nerve stimulation during labor in breech presentation: a case series. (Abstract)

Evaluation of the effectiveness of transcutaneous nerve stimulation during labor in breech presentation: a case series. To analyze the effectiveness of pain relief with transcutaneous electrical nerve stimulation (TENS) dispositive during labor in breech vaginal delivery and also to describe its tolerance and satisfaction.A randomized, double-blind, and placebo-controlled trial was conducted.Labor room of Complejo Hospitalario Universitario Insular-Materno Infantil (Spain).Ten women who met (...) the inclusion criteria of the clinical trial and also had a fetus breech presentation were randomly assigned to three groups.A portable TENS, Cefar Rehab 2pro®, unit was used to apply the experimental intervention, with different doses in the three groups in women during labor. The device intensity (amplitude) was individually adjusted to each participant's maximum sensory level. The pain was evaluated with visual analog scale (VAS). COMFORTS scale was used to measure women's satisfaction.A significant

2019 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Controlled trial quality: predicted high

32. Is induction of labor a reasonable option for breech presentation? (Abstract)

Is induction of labor a reasonable option for breech presentation? Whereas spontaneous onset of labor and vaginal delivery for breech presentation is considered to be a safe and effective option in selected cases, the safety of induction of labor is not established yet. The objectives of this study were to describe the outcomes of pregnancy in women induced with a fetus in breech presentation and compare the outcomes with those undergoing planned cesarean delivery.We performed a secondary (...) analysis of the observational prospective multicenter PREMODA study, including all singleton breech deliveries after 37 weeks in 174 centers in France and Belgium. We excluded women with spontaneous onset of labor, scarred uterus or intrauterine fetal death. Our study population consisted of women with either induction of labor or planned cesarean delivery. The primary outcome was the composite criteria of neonatal mortality and serious morbidity used in the Term Breech Trial and in the PREMODA

2019 Acta Obstetricia et Gynecologica Scandinavica

33. Effect of Intrathecal Bupivacaine Dose on the Success of External Cephalic Version for Breech Presentation: A Prospective, Randomized, Blinded Clinical Trial (Abstract)

Effect of Intrathecal Bupivacaine Dose on the Success of External Cephalic Version for Breech Presentation: A Prospective, Randomized, Blinded Clinical Trial Breech presentation is a leading cause of cesarean delivery. The use of neuraxial anesthesia increases the success rate of external cephalic version procedures for breech presentation and reduces cesarean delivery rates for fetal malpresentation. Meta-analysis suggests that higher-dose neuraxial techniques increase external cephalic (...) version success to a greater extent than lower-dose techniques, but no randomized study has evaluated the dose-response effect. We hypothesized that increasing the intrathecal bupivacaine dose would be associated with increased external cephalic version success.We conducted a randomized, double-blind trial to assess the effect of four intrathecal bupivacaine doses (2.5, 5.0, 7.5, 10.0 mg) combined with fentanyl 15 μg on the success rate of external cephalic version for breech presentation. Secondary

2017 EvidenceUpdates

34. Screening for breech presentation using universal late-pregnancy ultrasonography: A prospective cohort study and cost effectiveness analysis. Full Text available with Trip Pro

ultrasound. Where breech presentation was detected, an external cephalic version (ECV) was routinely offered. If the ECV was unsuccessful or not performed, the women were offered either planned cesarean section at 39 weeks or attempted vaginal breech delivery. To compare the likelihood of different mode of deliveries and associated long-term health outcomes for universal ultrasound to current practice, a probabilistic economic simulation model was constructed. Parameter values were obtained from the POP (...) by emergency cesarean section (EMCS) (27.9%). There were no women with undiagnosed breech presentation in labour in the entire cohort. On average, 40 scans were needed per detection of a previously undiagnosed breech presentation. The economic analysis indicated that, compared to current practice, universal late-pregnancy ultrasound would identify around 14,826 otherwise undiagnosed breech presentations across England annually. It would also reduce EMCS and vaginal breech deliveries by 0.7 and 1.0

2019 PLoS medicine

35. Cardiotocography in breech versus vertex delivery: an examiner-blinded, cross-sectional nested case-control study. Full Text available with Trip Pro

Cardiotocography in breech versus vertex delivery: an examiner-blinded, cross-sectional nested case-control study. The safety of vaginal breech delivery has been debated for decades. Although it has been shown to predispose infants to immediate depression, several observational studies have also shown that attempting vaginal breech delivery does not increase perinatal morbidity or low Apgar score at the age of five minutes. Cardiotocography monitoring is recommended during vaginal breech (...) delivery, but comparative data describing differences between cardiotocography tracings in breech and vertex deliveries is scarce. This study aims to evaluate differences in intrapartum cardiotocography tracings between breech and vertex deliveries in the final 60 min of delivery. A secondary goal is to identify risk factors for suboptimal neonatal outcome in the study population.One hundred eight breech and 108 vertex singleton, intended vaginal deliveries at term from a tertiary hospital with 5000

2016 BMC Pregnancy and Childbirth

36. New MRI Criteria for Successful Vaginal Breech Delivery in Primiparae Full Text available with Trip Pro

New MRI Criteria for Successful Vaginal Breech Delivery in Primiparae Even if lower vaginal delivery success rates and impaired neonatal short-term outcomes have been reported for primiparous women with breech presentation, vaginal breech delivery remains an option for carefully selected patients. Because Magnetic resonance imaging (MRI) pelvimetry can provide additional information on maternal pelvic morphology, we sought to identify new MRI parameters that predict successful vaginal breech (...) delivery.In this retrospective unicentre study, 240 primiparous women with breech presentation at term underwent MRI pelvimetry. For all patients vaginal delivery was planned, according to German guidelines and if the conjugata vera (CV) was ≥12 cm. The patients with uneventful vaginal deliveries and the patients who underwent a secondary caesarean section were compared according to pelvimetric parameters and outcomes. Regression analyses were performed.In the vaginal delivery group (n = 162, (67.5

2016 PloS one

37. Long-term childhood outcomes of breech presentation by intended mode of delivery: a population record linkage study. Full Text available with Trip Pro

Long-term childhood outcomes of breech presentation by intended mode of delivery: a population record linkage study. There is a lack of information on long-term outcomes by mode of delivery for term breech presentation. We aimed to compare childhood mortality, cerebral palsy, hospitalizations, developmental, and educational outcomes associated with intended vaginal breech birth (VBB) with planned cesarean section.Population birth and hospital records from New South Wales, Australia, were used (...) to identify women with non-anomalous pregnancies eligible for VBB during 2001-2012. Intended mode of delivery was inferred from labor onset and management. Death, hospital, and education records were used for follow up until 2014. Cox proportional hazards regression and modified Poisson regression were used for analysis.Of 15 281 women considered eligible for VBB, 7.7% intended VBB, 74.2% planned cesarean section, and intention was uncertain for 18.1%. Intended VBB did not differ from planned cesarean

2016 Acta Obstetricia et Gynecologica Scandinavica

38. Breech delivery at a University Hospital in Tanzania. Full Text available with Trip Pro

Breech delivery at a University Hospital in Tanzania. There is a global increase in rates of Cesarean delivery (CD). A minor factor in this increase is a shift towards CD for breech presentation. The aim of this study was to analyze breech births by mode of delivery and investigate short-term fetal and maternal outcomes in a low-income setting.The study design was cross-sectional and the setting was Muhimbili National Hospital (MNH), Dar-es-Salaam, Tanzania. Subjects were drawn from a clinical (...) database (1999-2010) using the following inclusion criteria: breech presentation, birth weight ≥ 2,500 g, single pregnancy, fetal heart sound at admission, and absence of pregnancy-related complication as indication for CD. Of 2,765 mothers who had a breech delivery, 1,655 met the inclusion criteria. Analyses were stratified by mode of delivery, taking into account also other birth characteristics. The outcome measures were perinatal death (stillbirths + in-hospital neonatal deaths) and moderate

2016 BMC Pregnancy and Childbirth

39. Twin delivery

be taken into consideration when planning/recommending mode of delivery D If first twin is in a breech presentation or non-cephalic delivery by C/S is recommended C Twin delivery Danish Society of Obstetrics and Gynecology 2020 Page 7 of 60 For MCDA-twins C/S delivery is recommended as a small (theoretical?) risk of intrapartum TTTS exists. No studies exist. D Delaying pregnancy of the second twin after first twin is born (DC) Delayed interval delivery (DID) Summary of evidence Evidence Delayed (...) Twin delivery Twin delivery Danish Society of Obstetrics and Gynecology 2020 Page 1 of 60 Twin delivery English summary of recommendations Approved by the Danish Society of Obstetrics and Gynecology 2020 Abbreviations DC Dichorionic DA Diamniotic FHR Fetal heart rate GA Gestational age IUGR Intrauterine Growth Restriction MA Monoamniotic MC Monochorionic Non-vertex Non-cephalic presentation PPH Postpartum hemorrhage sFGR Selective fetal growth restriction SGA Small for Gestational Age sIUGR

2020 Nordic Federation of Societies of Obstetrics and Gynecology

40. Breech presentation is associated with lower bone mass and area: findings from the Southampton Women's Survey. Full Text available with Trip Pro

Breech presentation is associated with lower bone mass and area: findings from the Southampton Women's Survey. We compared bone outcomes in children with breech and cephalic presentation at delivery. Neonatal whole-body bone mineral content (BMC) and area were lower in children with breech presentation. At 4 years, no differences in whole-body or spine measures were found, but hip BMC and area were lower after breech presentation.Breech presentation is associated with altered joint shape (...)  g lower whole-body BMC (95% CI -7.4 to - 0.9 g, P = 0.012) and 5.9 cm2 lower BA (- 10.8 to - 1.0 cm2, P = 0.019), but BMD was similar between groups (mean difference - 0.007, - 0.016 to 0.002 g/cm2, P = 0.146) adjusting for sex, maternal smoking, gestational diabetes, mode of delivery, social class, parity, ethnicity, age at scan, birthweight, gestational age and crown-heel length. There were no associations between breech presentation and whole-body outcomes at age 4 years, but, in similarly

2018 Osteoporosis International

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