Does breech delivery in an upright position instead of on the back improve outcomes and avoid cesareans?

  • 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.
Metadaten
Author:Frank LouwenORCiDGND, Betty-Anne Daviss, Kenneth Cuthbert Johnson-Davies, Anke Reitter
URN:urn:nbn:de:hebis:30:3-422845
URL:http://onlinelibrary.wiley.com/doi/10.1002/ijgo.12033/abstract
DOI:https://doi.org/10.1002/ijgo.12033
ISSN:0020-7292
ISSN:1879-3479
ISSN:0029-7292
Parent Title (English):International journal of gynecology & obstetrics, 2016
Publisher:Elsevier Science
Place of publication:Amsterdam [u. a.]
Document Type:Article
Language:English
Date of Publication (online):2016/12/19
Date of first Publication:2016/11/04
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2016/12/19
Tag:Breech delivery; Cesarean delivery; Delivery mode; Second stage of labor; Vaginal breech delivery; Vaginal delivery
Volume:2016
Page Number:28
First Page:1
Last Page:28
Note:
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.
HeBIS-PPN:423544713
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0