Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study

  • Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery into obstetricians’ daily practice, we need to gather knowledge from facilities who teach specialized obstetrical management. Methods: We performed a prospective cohort study on 140 vaginal deliveries out of breech presentation solely-managed by seven newly-trained physicians and compared fetal outcome as well as rates of manual assistance in respect to preexisting experience. Results: Fetal morbidity rate measured with a modified PREMODA score was not significantly different in three sub-cohorts sorted by preexisting expertise levels of managing obstetricians (experience groups EG, EG0: 2, 5%; EG1: 3, 7.5%; EG2: 1, 1.7%; p = 0.357). Manual assistance rate was significantly higher in EG1 (low experience level in breech delivery and only in dorsal position) compared to EG0 and EG2 (EG1 28, 70%; EG0: 14, 25%; EG2: 21, 35%; p = 0.0008). Conclusions: Our study shows that vaginal breech delivery with newly-trained obstetricians is a safe option whether or not they have advanced preexisting expertise in breech delivery. These data should encourage implementing vaginal breech delivery in clinical routine.

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Author:Lukas JenneweinORCiDGND, Dörthe BrüggmannORCiDGND, Kyra FischerGND, Florian RaimannORCiDGND, Hemma Roswitha Pfeifenberger, Lena Agel, Nadja Zander, Christine Eichbaum, Frank LouwenGND
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
Date of Publication (online):2021/05/14
Date of first Publication:2021/05/14
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/08/11
Tag:clinical teaching; delivery mode; vaginal breech
Issue:10, art. 2117
Page Number:9
First Page:1
Last Page:9
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0