#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The influence of the fetal leg position on the outcome in vaginally intended deliveries out of breech presentation at term – A FRABAT prospective cohort study


Autoři: Lukas Jennewein aff001;  Roman Allert aff001;  Charlotte J. Möllmann aff001;  Bettina Paul aff001;  Ulrikke Kielland-Kaisen aff001;  Florian J. Raimann aff002;  Dörthe Brüggmann aff001;  Frank Louwen aff001
Působiště autorů: FRABAT FRAnkfurt Breech At Term Study Group; Department of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, Frankfurt, Germany aff001;  Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225546

Souhrn

Introduction

Vaginal delivery out of a breech presentation in pregnancies at term are being re-implemented into clinical practice. Still, recommendations regarding exclusion criteria leading to caesarean sections are based on expert opinions, not on evidence-based guidelines. The difference in perinatal outcome and course of delivery in births with babies in frank breech position and babies in incomplete or complete breech presentation never has been investigated in a large patient cohort.

Objective

To compare perinatal outcome of vaginally intended breech deliveries between births out of frank breech position and incomplete/complete breech presentation.

Design

Prospective cohort study.

Sample

884 women at term with a singleton in frank breech presentation (FB) and 284 women with incomplete or complete breech presentation (CB) intending vaginal birth between January 2004 and December 2018.

Methods

Maternal and fetal outcome was compared between groups using Pearson’s Chi Square test. Birth duration parameters were analysed using logistic regression.

Results

There were no differences in cesarean section rates (FB: 25.1%, CB 22.2%, p = 0.317). Short-term fetal morbidity did not differ between groups (FB: 2.5%, CB: 2.8%, p = 0.761). In vaginal deliveries the necessity to perform manual assistance was significantly more frequent in deliveries of infants in CB (FB: 39.9%, CB: 51.6%, p = 0.0013). Cord loops (FB: 10.1%, CB: 18.0%, p = 0.0004) and cesarean sections necessary because of cord prolapses (FB: 1.4%, CB 8.1%, p = 0.005) were significantly more often in deliveries with babies in CB.

Conclusion

This study provides evidence, that perinatal morbidity is not associated with the fetal leg posture in vaginally intended breech deliveries. The higher risk for the need of manual assistance during vaginal birth in deliveries of babies out of complete or incomplete breech presentation suggests that obstetrical departments re-implementing the vaginal breech in their repertoire might start with births of babies out of frank breech presentation.

Klíčová slova:

Asphyxia – Cesarean section – Labor and delivery – Legs – Morbidity – Neonates – Pregnancy – Umbilical cord


Zdroje

1. Hickok DE, Gordon DC, Milberg JA, Williams MA, Daling JR. The frequency of breech presentation by gestational age at birth: a large population-based study. Am J Obstet Gynecol. 1992;166: 851–2. doi: 10.1016/0002-9378(92)91347-d 1550152

2. Annibale DJ, Hulsey TC, Wagner CL, Southgate WM. Comparative neonatal morbidity of abdominal and vaginal deliveries after uncomplicated pregnancies. Arch Pediatr Adolesc Med. 1995;149: 862–7. Available: http://www.ncbi.nlm.nih.gov/pubmed/7633538 doi: 10.1001/archpedi.1995.02170210036006 7633538

3. Schutte JM, Steegers EAP, Santema JG, Schuitemaker NWE, Van Roosmalen J, on behalf of the Maternal Mortality. Maternal deaths after elective cesarean section for breech presentation in the Netherlands. Acta Obstet Gynecol Scand. 2007;86: 240–243. doi: 10.1080/00016340601104054 17364290

4. Vistad I, Cvancarova M, Hustad BL, Henriksen T. Vaginal breech delivery: results of a prospective registration study. BMC Pregnancy Childbirth. 2013;13: 153. doi: 10.1186/1471-2393-13-153 23883361

5. Lewis G. Maternal mortality in the developing world: why do mothers really die? Obstet Med. 2008;1: 2–6. doi: 10.1258/om.2008.080019 27630738

6. Lewsi G DJ. Why Mothers Die 1997–1999. The Fifth Report of the Confidential Enquiries into Maternal Deaths in the United Kindom. RCOG Press. 2001.

7. Impey LWM, Murphy DJ GM. Management of Breech Presentation: Green-top Guideline No. 20b. BJOG An Int J Obstet Gynaecol. 2017;124: e151–e177. doi: 10.1111/1471-0528.14465 28299904

8. Melo P, Georgiou E, Hedditch A, Ellaway P, Impey L. External cephalic version at term: a cohort study of 18 years’ experience. BJOG An Int J Obstet Gynaecol. 2019;126: 493–499. doi: 10.1111/1471-0528.15475 30223309

9. Tsakiridis I, Mamopoulos A, Athanasiadis A, Dagklis T. Management of Breech Presentation: A Comparison of Four National Evidence-Based Guidelines. Am J Perinatol. 2019 [cited 15 Oct 2019]. doi: 10.1055/s-0039-1692391 31167240

10. Klemt A-S, Schulze S, Brüggmann D, Louwen F. MRI-based pelvimetric measurements as predictors for a successful vaginal breech delivery in the Frankfurt Breech at term cohort (FRABAT). Eur J Obstet Gynecol Reprod Biol. 2019;232: 10–17. doi: 10.1016/j.ejogrb.2018.09.033 30453166

11. Louwen F, Daviss BA, Johnson KC, Reitter A. Does breech delivery in an upright position instead of on the back improve outcomes and avoid cesareans? Int J Gynecol Obstet. 2017;136: 151–161. doi: 10.1002/ijgo.12033 28099742

12. Pschyrembel W. Praktische Geburtshilfe für Studierende und Ärzte. 1964. Available: https://books.google.de/books?id=OniVDwAAQBAJ&pg=PA295&lpg=PA295&dq=pschyrembel+steißlage&source=bl&ots=W2-Dt9Pow0&sig=ACfU3U1vxWlm-BLuOCTreH9UsAIriH-Oqw&hl=de&sa=X&ved=2ahUKEwj0g-LomZPjAhUiMewKHZqaDkkQ6AEwCXoECAkQAQ#v=onepage&q=pschyrembelstei%C3

13. Krause M, Fischer T, Feige A. [What effect does leg position in breech presentation have on mode of delivery and early neonatal morbidity?]. Z Geburtshilfe Neonatol. 201: 128–35. Available: http://www.ncbi.nlm.nih.gov/pubmed/9410517 9410517

14. Jennewein L, Kielland-Kaisen U, Paul B, Möllmann CJ, Klemt A-S, Schulze S, et al. Maternal and neonatal outcome after vaginal breech delivery at term of children weighing more or less than 3.8 kg: A FRABAT prospective cohort study. Simeoni U, editor. PLoS One. 2018;13: e0202760. doi: 10.1371/journal.pone.0202760 30138358

15. Wilcox R, Wilcox R. Comparing Two Groups. Introd to Robust Estim Hypothesis Test. 2017; 145–234. doi: 10.1016/B978-0-12-804733-0.00005–6

16. Goffinet F, Carayol M, Foidart J-M, Alexander S, Uzan S, Subtil D, et al. Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Obstet Gynecol. 2006;194: 1002–1011. doi: 10.1016/j.ajog.2005.10.817 16580289

17. Committee on Obstetric Practice ACOG. ACOG comittee opinion Number 745. 2018.

18. Joseph KS, Pressey T, Lyons J, Bartholomew S, Liu S, Muraca G, et al. Once More Unto the Breech. Obstet Gynecol. 2015;125: 1162–1167. doi: 10.1097/AOG.0000000000000824 25932844

19. Vlemmix F, Bergenhenegouwen L, Schaaf JM, Ensing S, Rosman AN, Ravelli ACJ, et al. Term breech deliveries in the Netherlands: did the increased cesarean rate affect neonatal outcome? A population-based cohort study. Acta Obstet Gynecol Scand. 2014;93: 888–896. doi: 10.1111/aogs.12449 25113411

20. Gannard-Pechin E, Ramanah R, Cossa S, Mulin B, Maillet R, Riethmuller D. La procidence du cordon: à propos d’une série sur 23 années d’activité. J Gynécologie Obs Biol la Reprod. 2012;41: 574–583. doi: 10.1016/j.jgyn.2012.06.001 22832243

21. Dilbaz B, Ozturkoglu E, Dilbaz S, Ozturk N, Sivaslioglu AA, Haberal A. Risk factors and perinatal outcomes associated with umbilical cord prolapse. Arch Gynecol Obstet. 2006;274: 104–107. doi: 10.1007/s00404-006-0142-2 16538441

22. Critchlow CW, Leet TL, Benedetti TJ, Daling JR. Risk factors and infant outcomes associated with umbilical cord prolapse: a population-based case-control study among births in Washington State. Am J Obstet Gynecol. 1994;170: 613–8. doi: 10.1016/s0002-9378(94)70238-1 8116723

23. Abalos E, Oladapo OT, Chamillard M, Díaz V, Pasquale J, Bonet M, et al. Duration of spontaneous labour in ‘low-risk’ women with ‘normal’ perinatal outcomes: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2018;223: 123–132. doi: 10.1016/j.ejogrb.2018.02.026 29518643

24. Salman L, Shmueli A, Aviram A, Hiersch L, Chen R, Gabbay-Benziv R. The association between neonatal head circumference and second stage duration. J Matern Neonatal Med. 2018; 1–7. doi: 10.1080/14767058.2018.1481386 29793365

25. IQTIG. Qualitätsreport Geburtshilfe 2017. 2018. Available: https://iqtig.org/downloads/auswertung/2017/16n1gebh/QSKH_16n1-GEBH_2017_BUAW_V02_2018-08-01.pdf

26. Hannah MEHWJ, Hewson SA, Hodnett ED, Saroj Saigal, Willan AR. Term breech trial. Lancet. 2001;357: 227. doi: 10.1016/S0140-6736(05)71322-2 11213118

27. Whyte H, Hannah ME, Saigal S, Hannah WJ, Hewson S, Amankwah K, et al. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: The international randomized Term Breech Trial. Am J Obstet Gynecol. 2004;191: 864–871. doi: 10.1016/j.ajog.2004.06.056 15467555

28. Glezerman M. Five years to the term breech trial: The rise and fall of a randomized controlled trial. Am J Obstet Gynecol. 2006;194: 20–25. doi: 10.1016/j.ajog.2005.08.039 16389006

29. Azria E, Kayem G, Langer B, Marchand-Martin L, Marret S, Fresson J, et al. Neonatal mortality and long-term outcome of infants born between 27 and 32 weeks of gestational age in breech presentation: The EPIPAGE cohort study. PLoS One. 2016. doi: 10.1371/journal.pone.0145768 26744838


Článek vyšel v časopise

PLOS One


2019 Číslo 12
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#