TY  - JOUR
A1  - Louwen, Frank
A1  - Daviss, Betty-Anne
A1  - Johnson-Davies, Kenneth Cuthbert
A1  - Reitter, Anke
T1  - Does breech delivery in an upright position instead of on the back improve outcomes and avoid cesareans?
T2  - International journal of gynecology & obstetrics, 2016
N2  - Objective: To compare breech outcomes when mothers delivering vaginally are upright, on their back, or planning cesareans. Methods: A retrospective cohort study was undertaken of all women who presented for singleton breech delivery at a center in Frankfurt, Germany, between January 2004 and June 2011. Results: Of 750 women with term breech delivery, 315 (42.0%) planned and received a cesarean. Of 269 successful vaginal deliveries of neonates, 229 in the upright position were compared with 40 in the dorsal position. Upright deliveries were associated with significantly fewer delivery maneuvers (OR 0.45, 95% CI 0.31–0.68) and neonatal birth injuries (OR 0.08, 95% CI 0.01–0.58), second stages that were on average shorter (1 vs 1.75 hours), and nonsignificantly decreased serious perineal lacerations (OR 0.34, 95% CI 0.05–3.99). When upright position was used almost exclusively, the cesarean rate decreased. Serious fetal and neonatal morbidity potentially related to birth mode was low, and similar for upright vaginal deliveries compared with planned cesareans (OR 1.37, 95% CI 0.10–19.11). Three neonates died; all had lethal birth defects. Forceps were never required. Conclusion: Upright vaginal breech delivery was associated with reductions in duration of the second stage of labor, maneuvers required, maternal/neonatal injuries, and cesarean rate when compared with vaginal delivery in the dorsal position.
KW  - Breech delivery
KW  - Cesarean delivery
KW  - Delivery mode
KW  - Second stage of labor
KW  - Vaginal breech delivery
KW  - Vaginal delivery
Y1  - 2016
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/42284
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-422845
UR  - http://onlinelibrary.wiley.com/doi/10.1002/ijgo.12033/abstract
SN  - 0020-7292
SN  - 1879-3479
SN  - 0029-7292
N1  - This article is protected by copyright. All rights reserved.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
VL  - 2016
SP  - 1
EP  - 28
PB  - Elsevier Science
CY  - Amsterdam [u. a.]
ER  -