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Breech Delivery

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41. A Simulator for Breech Extraction of the Second Twin. (Abstract)

A Simulator for Breech Extraction of the Second Twin. Breech extraction of a second twin is a skill useful for any health care provider planning on undertaking vaginal delivery of twins. However, training opportunities in this skill may be limited.Using readily available supplies, a reusable model neoprene uterus can be constructed, as can a balloon model to simulate a fetus in the amniotic cavity.The model allowed demonstration of skills expected of trainees and is easy to construct (...) . A simulated vagina addition increased extraction difficulty and increased the probability of balloon (amniotic sac) rupture during simulation. A hysterotomy addition enhanced model applicability for use at simulated cesarean delivery of the breech fetus.This educational device for simulation of breech extraction realistically simulates a fetus suspended in an amniotic cavity and challenges learners to use tactile cues for prompt and proper identification, grasping, and delivery of the fetal foot or feet.

2018 Obstetrics and Gynecology

42. Preterm Breech Presentation: A Comparison of Intended Vaginal and Intended Cesarean Delivery. Full Text available with Trip Pro

Preterm Breech Presentation: A Comparison of Intended Vaginal and Intended Cesarean Delivery. To study the association of the intended mode of delivery and perinatal morbidity and mortality among breech fetuses who are delivered preterm.We conducted a nationwide cohort study of women with a singleton pregnancy in breech presentation who delivered preterm (26 0/7-36 6/7 weeks of gestation) in the years 2000-2011. We compared perinatal outcomes according to the intended and actual mode (...) of delivery using multivariate logistic regression analysis. We performed subgroup analyses of gestational age and parity.We studied 8,356 women with a preterm singleton breech delivery. Intended cesarean delivery (n=1,935) was not associated with a significant reduction in perinatal mortality compared with intended vaginal delivery (n=6,421) (1.3% compared with 1.5%; adjusted odds ratio [OR] 0.97, 95% confidence interval [CI] 0.60-1.57). However, the composite of perinatal mortality and morbidity

2015 Obstetrics and Gynecology

43. Commentary on 'A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant'. (Abstract)

Commentary on 'A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant'. 25488089 2015 02 20 2018 12 02 1471-0528 121 Suppl 7 2014 Dec BJOG : an international journal of obstetrics and gynaecology BJOG Commentary on 'A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant'. 54-7 10.1111/1471-0528.13155 Hezelgrave Nl N Division (...) of Women's Health, King's College, London, UK. Anderson-Knight H H Webster L L Shennan Ah A eng Journal Article Comment England BJOG 100935741 1470-0328 AIM IM BJOG. 2014 Dec;121 Suppl 7:48-53 25488088 Breech Presentation Cesarean Section Delivery, Obstetric Female Humans Obstetric Labor, Premature Pregnancy 2014 09 11 2014 12 10 6 0 2014 12 10 6 0 2015 2 24 6 0 ppublish 25488089 10.1111/1471-0528.13155

2015 BJOG : an international journal of obstetrics and gynaecology Controlled trial quality: uncertain

44. Humerus Diaphysis Fracture in a Newborn during Vaginal Breech Delivery Full Text available with Trip Pro

Humerus Diaphysis Fracture in a Newborn during Vaginal Breech Delivery While most obstetricians are familiar with fracture of the clavicle in newborns during birth, an unlucky minority of obstetricians has encountered long-bone fractures in newborns as well. This complication is traumatic not only for the neonate, but also for the family and the obstetrician; it is also difficult to explain. Fortunately, the long-term prognosis for fracture of the long bones is excellent. Both vaginal (...) and cesarean breech deliveries and maneuvers can be responsible for birth traumas, including long-bone fractures. This case report presents a newborn with breech presentation delivered vaginally that resulted in humerus diaphysis fracture.

2015 Case reports in obstetrics and gynecology

45. A retrospective study to correlate breech presentation and enhanced risk of postspinal hypotension during cesarean delivery Full Text available with Trip Pro

A retrospective study to correlate breech presentation and enhanced risk of postspinal hypotension during cesarean delivery Subarachnoid blockade for cesarean section still poses a threat of profound hypotension and can result in unstable maternal and fetal hemodynamics. The correlation of fetal breech and vertex presentation with the occurrence of hypotension under spinal anesthesia is reviewed in this retrospective, double-blind study.The study was conducted on pregnant females scheduled (...) for a lower segment cesarean section between January 2014 and December 2014. After applying inclusion criteria, 568 patients were recruited in the study out of which 363 had vertex and 184 patients had breech presentation. They were divided into two groups, Group I and Group II. The monitoring and therapeutic data (blood pressure, heart rate, arterial oxygen saturation, and dose of vasopressor/atropine) recovered from automated data analysis were analyzed retrospectively for prevalence of hypotension

2015 Local and regional anesthesia

46. Risks of vaginal breech delivery at term compared to elective caesarean section - Reply on comment by Page. (Abstract)

Risks of vaginal breech delivery at term compared to elective caesarean section - Reply on comment by Page. 25676439 2015 04 29 2018 12 02 1600-0412 94 4 2015 Apr Acta obstetricia et gynecologica Scandinavica Acta Obstet Gynecol Scand Risks of vaginal breech delivery at term compared to elective cesarean section--reply to comment by Page. 442 10.1111/aogs.12603 Vlemmix Floortje F Department of Obstetrics and Gynecology, Academic Medical Center, University of Amsterdam, Amsterdam (...) , the Netherlands. Mol Ben Willem BW Kok Marjolein M all co-authors eng Letter Comment 2015 03 01 United States Acta Obstet Gynecol Scand 0370343 0001-6349 IM Acta Obstet Gynecol Scand. 2015 Apr;94(4):441 25311000 Acta Obstet Gynecol Scand. 2014 Sep;93(9):888-96 25113411 Breech Presentation Cesarean Section statistics & numerical data Female Humans Pregnancy 2015 2 14 6 0 2015 2 14 6 0 2015 4 30 6 0 ppublish 25676439 10.1111/aogs.12603

2015 Acta Obstetricia et Gynecologica Scandinavica

47. Prehospital Breech Delivery with Fetal Head Entrapment -A Case Report and Review. (Abstract)

Prehospital Breech Delivery with Fetal Head Entrapment -A Case Report and Review. We present a case in which an emergency medical services (EMS) crew was called for a precipitous breech delivery with fetal head entrapment that was unrelieved following standard prehospital interventions and eventually resulted in neonatal cardiac arrest and death. Although this is a rare occurrence, EMS responders must have adequate training and guidelines on how to assist with vaginal delivery of breech

2015 Prehospital emergency care

48. Delivery of breech presentation at term gestation in Canada, 2003-2011. (Abstract)

Delivery of breech presentation at term gestation in Canada, 2003-2011. To examine neonatal mortality and morbidity rates by mode of delivery among women with breech presentation at term gestation.We carried out a population-based cohort study examining neonatal outcomes among term, nonanomalous singletons in breech presentation among all hospital deliveries in Canada (excluding Quebec) between 2003 and 2011. Mode of delivery was categorized into vaginal delivery, cesarean delivery in labor (...) , and cesarean delivery without labor. Composite neonatal mortality and morbidity (death, assisted ventilation, convulsions, or specific birth injury) was the primary outcome. Logistic regression was used to estimate the independent effects of mode of delivery.The study population included 52,671 breech deliveries; vaginal deliveries increased from 2.7% in 2003 to 3.9% in 2011, and cesarean deliveries in labor increased from 8.7% to 9.8%. Composite neonatal mortality and morbidity rates at 37 weeks

2015 Obstetrics and Gynecology

49. Assisted breech vaginal delivery of dicephalus dipus dibrachius conjoined twins: a case report. (Abstract)

Assisted breech vaginal delivery of dicephalus dipus dibrachius conjoined twins: a case report. Conjoined twinning is a rare congenital anomaly. Even after significant advancement in the health care delivery system in developing countries, adequate antenatal care of pregnant patients and antenatal diagnosis of congenital malformations by radiological techniques like sonogram need to be emphasized.A 25-year-old woman (G1P0) at 38 weeks' gestation vaginally delivered stillborn dicephalus male (...) twins with 2 heads, 2 necks, and a common trunk with 2 arms and 2 legs at Kasturba Hospital. The fetuses were in breech presentation and were delivered using assisted breech vaginal delivery. The conjoint nature of the fetuses remained undiagnosed antenatally and was clinically unsuspected during the intrapartum period. It was only confirmed after delivery. The intrapartum and postpartum course was uncomplicated, and the patient was discharged home on postpartum day 2.The diagnosis of conjoined

2015 Journal of Reproductive Medicine

50. Pregnancy outcomes in breech presentation analyzed according to intended mode of delivery. Full Text available with Trip Pro

Pregnancy outcomes in breech presentation analyzed according to intended mode of delivery. Optimal mode of delivery in breech presentation has been widely examined and debated. The aim of this study was to compare perinatal and maternal outcomes with either a policy of planned vaginal delivery or planned cesarean section in breech presentation.This was a registry-based retrospective cohort study from Turku University Hospital, Finland with 1418 singleton breech deliveries at term over a period (...) of 11 years (January 2002 to December 2012). Data were collected from the mothers' medical records.Apgar scores at 5 min as well as umbilical artery pH values were significantly lower in the planned vaginal breech delivery group compared with the planned cesarean section group, suggesting a short-lasting delayed recovery after birth. There were more puerperal infections in planned cesarean section group compared with the planned vaginal delivery group.The results confirm that planned vaginal breech

2015 Acta Obstetricia et Gynecologica Scandinavica

51. Neonatal outcome of singleton term breech deliveries in Norway from 1991 to 2011. (Abstract)

Neonatal outcome of singleton term breech deliveries in Norway from 1991 to 2011. The objective of this study was to examine the association between planned mode of delivery and neonatal outcomes in breech deliveries.In this retrospective cohort study we studied singleton term breech deliveries in Norway from 1991 to 2011 (n = 30 861) using the Medical Birth Registry of Norway. We compared planned vaginal delivery with planned cesarean delivery across two time periods: from 1 January 1991 to 31 (...) 34.4 to 51.3% over the period. Simultaneously, early neonatal mortality rate (0-6 days) declined (from 0.10% to 0.04%, p = 0.04). During the second period, 30.7% of term breech presentations were delivered vaginally. Eight deaths in the planned vaginal vs. four in the planned cesarean groups were observed (OR 2.11 95% CI 0.64-7.01). Neonatal morbidity outcomes were significantly worse in planned vaginal deliveries compared with planned cesarean deliveries in both periods.Overall intrapartum

2015 Acta Obstetricia et Gynecologica Scandinavica

52. Operative vaginal delivery

whether the requirements for safe operative vaginal delivery are still present. Forceps delivery Indications • Trapped foetal head with breech delivery • Face presentation with the chin anterior and forehead presentation • Macerated foetus • In addition all the above mentioned indications for ventouse delivery, if the doctor is skilled in forceps delivery • In the following clinical situations forceps delivery may be superior to ventouse: o Prematurity (< 34+0) o Maternal condition that precludes (...) contraindications • Forceps are applicable with prematurity. No evidence exists as to the lowest GA for safe forceps delivery. With extreme prematurity extraordinary precaution must however be applied in traction force Types of forceps https://stratog.rcog.org.uk/tutorial/forceps/types-of-forceps-4968 Procedure Below is a description of cephalic forceps delivery. Forceps breech delivery and forceps delivery with C/S are both special indications described in detail in other guidelines. • Informed consent

2019 Nordic Federation of Societies of Obstetrics and Gynecology

53. The Dangerous Allure of Breech Birth at Home – and a Problematic New Paper

provide to argue against all this? It was published in in BMC Pregnancy and Childbirth by an American obstetrician, Stuart Fischbein, and doula and midwife’s assistant, . This is what they report: 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 (...) The Dangerous Allure of Breech Birth at Home – and a Problematic New Paper The Dangerous Allure of Breech Birth at Home – and a Problematic New Paper | Absolutely Maybe PLOS Blogs Staff Blogs Blogs by Topic Biology & Life Sciences Earth & Environmental Sciences Multi-disciplinary Sciences Medicine & Health Research Analysis & Scientific Policy Diverse perspectives on science and medicine Staff Blogs Blogs by Topic Biology & Life Sciences Earth & Environmental Sciences Multi-disciplinary

2018 Absolutely Maybe

54. CRACKCast E180 – Labor & Delivery

with cesarean section and will therefore face the prospect of an extremely high-risk vaginal delivery. As expected, these abnormal deliveries increase the risk of fetal and maternal complications. Aggressive attempts to obtain obstetric, neonatal, and anesthesia are warranted! According to Rosen’s: Breech presentation = 1/25 live births Shoulder dystocia = 1/300 live births Face presentation = 1/550 live births Brow presentation = 1/1400 live births According to Uptodate: Occiput posterior – 1/19 deliveries (...) Occiput transverse – no clear incidence known (? 8%) Breech – 1/33 deliveries Face – 1/600 to 1/800 deliveries (Left mentum anterior, right mentum anterior, and right mentum posterior) Brow – 1/500 to 1/4000 deliveries Transverse lie – 1/833 deliveries (back down vs. back up) Compound – 1/1500 deliveries 11) List 3 major reasons for shoulder dystocia. Describe the stepwise progression of management of a shoulder dystocia. Normally, the shoulders negotiate the maternal pelvis in sequential fashion

2018 CandiEM

55. Uptake of external cephalic version for term breech presentation: an Australian population study, 2002-2012. Full Text available with Trip Pro

Uptake of external cephalic version for term breech presentation: an Australian population study, 2002-2012. The safety, efficacy, and cost-effectiveness of external cephalic version (ECV) for term breech presentation has been demonstrated. Clinical guidelines recommend ECV for all eligible women, but the uptake of this procedure in the Australian healthcare setting is unknown. This study aimed to describe ECV uptake in New South Wales, the most populous state of Australia, during 2002 to 2012 (...) .Data from routine hospital and birth records were used to identify ECVs conducted at ≥36 weeks' gestation. Women with ECV were compared to women who were potentially eligible for but did not have ECV. Eligibility for ECV was based on clinical guidelines. For those with ECV, birth outcomes following successful and unsuccessful procedures were examined.In N = 32,321 singleton breech pregnancies, 10.5% had ECV, 22.3% were ineligible, and 67.2% were potentially eligible but did not undergo ECV

2017 BMC Pregnancy and Childbirth

56. Amnioinfusion for women with a singleton breech presentation and a previous failed external cephalic version: a randomized controlled trial. (Abstract)

Amnioinfusion for women with a singleton breech presentation and a previous failed external cephalic version: a randomized controlled trial. Our trial aimed to assess the effectiveness of amnioinfusion for a second attempt at external cephalic version (ECV).This open randomized controlled trial was planned with a sequential design. Women at a term ≥36 weeks of gestation with a singleton fetus in breech presentation and a first unsuccessful ECV were recruited in two level-3 maternity units (...) . They were randomly allocated to transabdominal amnioinfusion with a 500-mL saline solution under ultrasound surveillance or no amnioinfusion before the second ECV attempt. Trained senior obstetricians performed all procedures. The primary outcome was the cephalic presentation rate at delivery. Analyses were conducted according to intention to treat (NCT00465712).Recruitment difficulties led to stopping the trial after a 57-month period, 119 women were randomized: 59 allocated to amnioinfusion + ECV

2017 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

57. Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study. Full Text available with Trip Pro

Risk factors associated with adverse perinatal outcome in planned vaginal breech labors at term: a retrospective population-based case-control study. Vaginal breech delivery is associated with adverse perinatal outcome. The aim of this study was to identify factors associated with adverse perinatal outcome in term breech pregnancies, and to provide clinicians an aid in selecting women for a trial of vaginal labor with the fetus in breech position.We conducted a retrospective, nationwide (...) , Finnish population-based case-control study. All planned singleton vaginal deliveries at term with the fetus in breech position between the years 2005 and 2014 were analyzed. The study's end point was a composite set of adverse perinatal outcomes. All infants with an adverse outcome were compared to the infants with normal outcomes. A multivariate logistic regression model was used to analyze the data.An adverse perinatal outcome was recorded for 73 (1.5%) infants. According to the study results fetal

2017 BMC Pregnancy and Childbirth

58. Term Cesarean Delivery in the First Pregnancy is Not Associated with an Increased Risk for Preterm Delivery in the Subsequent Pregnancy. (Abstract)

weeks), early preterm delivery (< 34 weeks), and small for gestational age (SGA) birth.Of a total of 6,456 linked pregnancies, 2,284 deliveries were matched; 1142 were preceded by cesarean delivery and 1142 were preceded by vaginal delivery. The main indications for cesarean delivery in the first pregnancy were dystocia in 703 (61.5%), non-reassuring fetal status in 222 (19.4%), breech presentation in 100 (8.8%), and other in 84 (7.4%). The mean (standard deviation) gestational ages at delivery (...) Term Cesarean Delivery in the First Pregnancy is Not Associated with an Increased Risk for Preterm Delivery in the Subsequent Pregnancy. Prior studies have reported an increased risk for preterm delivery following a term cesarean delivery. However, these studies did not adjust for high risk conditions related to the first cesarean delivery and are known to recur.To determine if there is an association between term cesarean delivery in the first pregnancy and subsequent spontaneous or indicated

2019 American Journal of Obstetrics and Gynecology

59. Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery. (Abstract)

Delivery mode and neonatal outcome after a trial of external cephalic version (ECV): a prospective trial of vaginal breech versus cephalic delivery. To examine the delivery mode and neonatal outcome after a trial of external cephalic version (ECV) procedures.This is an interim analysis of an ongoing larger prospective off-centre randomised trial, which compares a clinical hypnosis intervention against neuro-linguistic programming (NLP) of women with a singleton breech foetus at or after 37(0/7 (...) ) (259 days) weeks of gestation and normal amniotic fluid index. Main outcome measures were delivery mode and neonatal outcome.On the same day after the ECV procedure two patients (2 %), who had unsuccessful ECVs, had Caesarean sections (one due to vaginal bleeding and one due to pathological CTG). After the ECV procedure 40.4 % of women had cephalic presentation (n = 38) and 58.5 % (n = 55) remained breech presentation. One patient remained transverse presentation (n = 1; 1.1 %). Vaginal delivery

2013 Archives of gynecology and obstetrics

60. Breech Presentation

window. Related Studies (from Trip Database) Ontology: Breech Presentation (C0006157) Definition (NCI) A fetal presentation in which the baby descends into the birth canal with hips, buttocks or its foot first during delivery.(NICHD) Definition (MSH) A malpresentation of the FETUS at near term or during OBSTETRIC LABOR with the fetal cephalic pole in the fundus of the UTERUS. There are three types of breech: the complete breech with flexed hips and knees; the incomplete breech with one or both hips (...) , Position of breech presentatn , Malpos fetus breech present , breech presentation of fetus (diagnosis) , breech presentation of fetus , a buttocks presentation was observed , breech presentation (physical finding) , buttocks presentation , buttocks presentation (physical finding) , breech presentation , Breech Presentation [Disease/Finding] , breech presentations , Breech presentation NOS (finding) , Breech delivery (disorder) , Breech delivery , Breech presentation (disorder) , Breech presentation

2018 FP Notebook

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