scholarly journals Fetomaternal outcome in breech delivery

2018 ◽  
Vol 7 (6) ◽  
pp. 2480
Author(s):  
Bhavesh B. Airao ◽  
Vishal M. Sharma ◽  
Ravi A. Zala ◽  
Vimal Vasava
Keyword(s):  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Mortality And Morbidity ◽  
Breech Delivery ◽  
Different Types

Background: Breech Presentation is the commonest of all malpresentations. Vaginal delivery of the breech presentations at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation. The objectives of the present study are to know the common causes leading to breech presentation. Further, to compare the different management protocols and outcome in different types of breech presentation.  Also, to know the perinatal morbidity and mortality associated with different types of breech presentation nd comparison of perinatal morbidity and mortality with vaginal delivery against cesarean section.Methods: This is a retrospective study of randomized 100 cases of pregnant women in labour with breech presentations after 28 weeks or more attending C U Shah Medical College, Surendranagar, over a period of May 2012 to April 2014.Results: Out of 100 patients breech presentation was more common in booked patients and multigravida. In primi and multigravidae patients, caesarean delivery was more compared to assisted breech delivery. Perinatal outcome was good in majority of the patients in both extended and complete breech with an incidence of 94% and 88% respectively. perinatal outcome was good in caesarean section with 100% compared to assisted breech delivery 93%.Conclusions: The balanced decision about the mode of delivery on a case by case basis as well as conduct, training and regular drills of assisted breech delivery will go a long way to optimize the outcome of breech presentation like ours. Delivery of breech fetus when labor and delivery is supervised and or conducted by experienced obstetrician lowers maternal morbidity, neonatal morbidity and mortality.

scholarly journals Comparison of Perinatal Outcome of Breech Presentation between Vaginal Delivery and Cesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 4 ◽  
Author(s):  
Buddhi Kumar Shrestha ◽  
Subha Shrestha
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Perinatal Outcome ◽  
College Teaching ◽  
Breech Presentation ◽  
Morbidity And Mortality ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Vaginal Deliveries ◽  
Significant Difference

Introduction: Many times, parturient opt for labour and vaginal breech delivery even after informing increased perinatal risks. Vaginal breech deliveries are undertaken with the reasons like avoidance of cesarean section in next pregnancy, null risk of operative and anesthetic hazards, ability to resume early all household works after vaginal birth, etc. The purpose of this study is to compare the perinatal outcome of breech deliveries in singleton breech presentation between vaginal breech delivery and cesarean section.   Methods: A retrospective study was done in Lumbini Medical College Teaching Hospital for the duration of one year (December 2014 to November 2015). Data of perinatal outcome of breech deliveries were collected from the hospital records. The records of neonatal examination were also collected. The primary outcomes included were neonatal morbidity and mortality.   Results: Out of 80 selected women with breech presentation, 42 of them had vaginal deliveries and 38 women had undergone caesarean section. The perinatal mortality was 4.8% and morbidity was 2% in vaginal breech deliveries. There was no significant difference of APGAR score in the two groups at any time. Similarly, there was no significant difference in perinatal morbidity and mortality in the two groups. Nulliparous women were more likely to deliver by Cesarean section.   Conclusion:  In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labour, planned vaginal breech delivery of singleton fetus in breech presentation remains a safe option that can be offered to women.

scholarly journals Impact of Implementation of a Breech Clinic in a Tertiary Hospital.

2020 ◽  
Author(s):  
Sara Derisbourg ◽  
Elena Costa ◽  
Laura De Luca ◽  
Soraya Amirgholami ◽  
Valery Bogne Kamdem ◽  
...  
Keyword(s):  
Care Pathway ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Primary Objective ◽  
Neonatal Outcomes ◽  
Tertiary Referral Centre ◽  
Breech Delivery ◽  
Vaginal Deliveries ◽  
Before And After

Abstract BACKGROUND The incidence of breech presentation in single pregnancies at term is between three to five percent. In order to support eligible women in their choice of mode of delivery, a dedicated breech clinic with a care pathway was developed in December 2015 in a tertiary referral centre in Brussels. The primary objective of this study was to evaluate the vaginal birth rate before and after the introduction of a dedicated breech clinic. The secondary objective was to compare the early neonatal outcomes before and after the breech clinic was introduced. METHODS This was a single centre retrospective and prospective study. The inclusion criteria were term (from 37 weeks), singleton fetus and breech presentation at delivery. The exclusion criteria were suspected intrauterine growth restriction, severe fetal malformations and intrauterine fetal demise. We used a composite outcome as an indicator of neonatal morbidity and mortality. RESULTS After the introduction of the breech clinic, we observed a significant increase in planned vaginal delivery from 7.4% (12/162) to 53.0% (61/115) (OR: 13.5; 95%CI: 6.7-27.0). The effective vaginal breech delivery rate (planned and unexpected) significantly increased from 4.3% (7/162) pre-implementation of breech clinic to 43.5% (50/115) post-implementation (OR: 17.0; 95%CI: 7.3-39.6). Neonatal outcomes were not statistically different between the before and after periods. CONCLUSION The introduction of a dedicated breech clinic has led to an increase in vaginal deliveries for breech babies without adversely affecting neonatal outcomes .

scholarly journals REVIVAL OF VAGINAL BREECH DELIVERY

1969 ◽  
Vol 5 (1) ◽  
pp. 597-602
Author(s):  
NASIM AKHTAR
Keyword(s):  
Cesarean Section ◽  
Neonatal Mortality ◽  
Post Partum ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Maternal Complications ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Emergency Cesarean

BACKGROUND: Since the publication of term breech trail there had been a dramatic changeworldwide from selective to planned Cesarean Section for all women with breech presentation at term.This high cesarean section rate led to adverse consequences in subsequent pregnancy &on futurefertility. Choice of safest mode of delivery has always been a dilemma.OBJECTIVE: Prospective interventional study. This study was done to determine the safety of vaginalbreech birth in terms of neonatal & maternal complications, so that to encourage the trend of breechdelivery in carefully selected cases & to discourage the trend of routinely recommending cesareansection for all gravidas with fetus in breech presentation at term. The study was conducted atDepartment of Obstetrics & Gynae Mardan Medical Complex from January 2010 to December 2015.PATIENTS & METHOD: About 809 patients with singleton pregnancy with breech presentation wereincluded. Decision about mode of delivery was taken on the basis of clinical judgment and ultrasoundwhich was further reviewed in the light of rate of progress during labour .Delivery was conducted byexperienced obstetrician. Mother & infants were followed up to 6 wks post partum. The primaryoutcome was neonatal mortality, infant mortality & serious infant morbidity.RESULTS: out of 809 total patients with breech presentation, 714 were planned for vaginal delivery674 delivered (83%) while 40 pts (5%) had emergency Cesarean Sections.95 patients (12%) hadElective cesarean section. In the delivery group two (0.29%) neonates had serious neonatal morbidity. Inthe cesarean group there was no serious neonatal morbidity. Infection & blood loss was greater in thecesarean group. There were no serious maternal complications in the vaginal delivery group. Thedifference between neonatal morbidity, perinatal mortality &neonatal mortality between the two groupswas not significant.CONCLUSION: Vaginal breech delivery is still a safe option which better suits the clinical situation&problems of our patients .In our set up, Cesarean section should not be routinely advised to patientswith breech presentation no matter it may be the best management option in developed countries.Careful case selection & vigilant monitoring of progress of labour will save many patients fromunnecessary section without costing extra morbidity & mortality.KEY WORDS: Breech presentation, Breech Delivery, Cesarean section, Apgar score.

scholarly journals Comparative study of perinatal outcome between abdominal and vaginal route of delivery in case of breech presentation

2018 ◽  
Vol 7 (9) ◽  
pp. 3758
Author(s):  
Gourav Ranjan Tripathy ◽  
M. Smitha ◽  
Anand Acharya
Keyword(s):  
Caesarean Section ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Breech Presentation ◽  
Vaginal Route ◽  
Breech Delivery ◽  
Labour Room ◽  
Route Of Delivery

Background: Breech presentation is also one of the most interesting subjects in obstetrics as no other malpresentation has so many manoeuvres during vaginal delivery and their impact on perinatal mortality. The mode of delivery also depends on so many variables like parity, type of breech presentation, associated obstetric complications, estimated birth weight etc and also from obstetrician point of view.Methods: Pregnant mother with breech presentation of gestational age 32 weeks or more were included in this study. Multiple pregnancy with first baby in breech presentation were excluded from this study. New born baby with gross congenital anomalies like anencephaly, omphalocele were excluded from this study. The cases for present study were collected from antenatal OPD, labour room, High-risk ward and Post-natal ward of KIMS & RF from June 2016 to December 2017.Results: Out of 61 cases of caesarean section there were 4 cases (6.55%) of neonatal death. PNM among the 100 cases was 4% in caesarean section. In 32 assisted breech delivery cases there were 8 cases (25%) of perinatal death. PNM among the 100 cases was 8% in assisted breech delivery. Out of 4 cases of breech extractions there were 3 cases (75%) of perinatal death. PNM among the 100 cases was 3% in breech extraction.Conclusions: Present study suggests that breech delivery should preferably be always managed in the hospital by skilled and experienced obstetrician with an assistant in collaboration with a pediatrician and an anesthetist. As good numbers of babies were premature a good premature care unit should be pre-managed under the supervision of a pediatrician.

scholarly journals Perinatal Outcome of Vaginal Breech Delivery versus Caesarean Breech Delivery in a Tertiary Care Center

2018 ◽  
Vol 56 (212) ◽  
pp. 796-799 ◽  
Author(s):  
Rajendra Kumar Chaudhary ◽  
Rajan Ghimire ◽  
Deepak Raj Kafle
Keyword(s):  
Perinatal Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Breech Presentation ◽  
Study Data ◽  
Perinatal Morbidity ◽  
Vaginal Route ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Significant Odds Ratio

Introduction: Breech delivery has always been matter of interest in obstetrics. Cesarean breech delivery has been preferred method of delivery. We aim to find out any differences in outcome between vaginal breech delivery and cesarean breech delivery in our setup. Methods: Data were collected from record book of Department of Gynaecology and obstetrics, Pokhara Academy of Health Sciences, Kaski, Nepal. Pregnant with breech presentation who had delivery in the centre from 2074 Baishak to 2074 chaitra were enrolled in the study. Data of 174 patients were analysed among which 74 underwent vaginal delivery for breech and 110 underwent cesarean breech delivery. Results: Only 1 (1.6%) of newborn delivered by vaginal route were admitted to NCU vs 17 (15.5% )in cesarean group which was significant (odds ratio= 0.071, 95% C.I 0.009-0.574; p= 0.004). There was only one death of newborn which was delivered by vaginal route. Mean APGAR score at 1 and 5 minute in vaginal breech delivery was 6 and 7 and in cesarean breech delivery was 6 and 8. Conclusions: Though perinatal morbidity was more with cesarean breech delivery but further study with more sample size is needed before reaching conclusion.

scholarly journals Impact of Implementation of a Breech Clinic in a Tertiary Hospital.

2020 ◽  
Author(s):  
Sara Derisbourg ◽  
Elena Costa ◽  
Laura De Luca ◽  
Soraya Amirgholami ◽  
Valery Bogne Kamdem ◽  
...  
Keyword(s):  
Care Pathway ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Morbidity ◽  
Primary Objective ◽  
Neonatal Outcomes ◽  
Tertiary Referral Centre ◽  
Breech Delivery ◽  
Vaginal Deliveries ◽  
Before And After

Abstract BACKGROUND The incidence of breech presentation in single pregnancies at term is between three to five percent. In order to support eligible women in their choice of mode of delivery, a dedicated breech clinic with a care pathway was developed in December 2015 in a tertiary referral centre in Brussels. The primary objective of this study was to evaluate the vaginal birth rate before and after the introduction of a dedicated breech clinic. The secondary objective was to compare the early neonatal outcomes before and after the breech clinic was introduced. METHODS This was a single centre retrospective and prospective study. The inclusion criteria were term (from 37 weeks), singleton fetus and breech presentation at delivery. The exclusion criteria were suspected intrauterine growth restriction, severe fetal malformations and intrauterine fetal demise. We used a composite outcome as an indicator of neonatal morbidity and mortality. RESULTS After the introduction of the breech clinic, we observed a significant increase in planned vaginal delivery from 7.4% (12/162) to 53.0% (61/115) (OR: 13.5; 95%CI: 6.7-27.0). The effective vaginal breech delivery rate (planned and unexpected) significantly increased from 4.3% (7/162) pre-implementation of breech clinic to 43.5% (50/115) post-implementation (OR: 17.0; 95%CI: 7.3-39.6). Neonatal outcomes were not statistically different between the before and after periods. CONCLUSION The introduction of a dedicated breech clinic has led to an increase in vaginal deliveries for breech babies without adversely affecting neonatal outcomes .

TERM BREECH DELIVERY

2005 ◽  
Vol 16 (4) ◽  
pp. 289-322
Author(s):  
ANDREAS HERBST ◽  
KARIN KÄLLÉN
Keyword(s):  
Interim Analysis ◽  
Perinatal Outcome ◽  
Controlled Trial ◽  
Case Control ◽  
Perinatal Morbidity ◽  
Case Control Studies ◽  
Mortality And Morbidity ◽  
Breech Delivery ◽  
Significant Difference ◽  
Randomised Controlled

In October 2000, Hannah et al published a randomised controlled trial comparing perinatal and maternal outcome between planned vaginal and planned caesarean deliveries of term breech pregnancies. The study was closed after an interim analysis, showing a reduced perinatal morbidity and mortality with planned caesarean section. The result was not unexpected, although a trial like this had been called for over many years to resolve the issue. Many cohort- and case-control studies, and two small randomised studies had been performed since 1959, when Wright reported a reduced perinatal mortality and morbidity with CS. A few large registry studies had shown a better perinatal outcome with caesarean delivery, whereas smaller studies often showed no statistically significant difference in outcome, often with the conclusion that vaginal delivery (VD) is safe.

Oligohydramnios and its perinatal outcome

2020 ◽  
Vol 9 (12) ◽  
pp. 4965
Author(s):  
Rita Saxena ◽  
Brinda Patel ◽  
Anjana Verma
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Morbidity And Mortality ◽  
Medical Illness ◽  
Perinatal Morbidity ◽  
Nicu Admission

Background: Oligohydramnios is one of the major causes of perinatal morbidity and mortality. The sonographic diagnosis of oligohydramnios is usually based on an AFI≤5 cm or on a single deepest pocket of amniotic fluid≤2 cm3. Our study was aimed to study the perinatal outcome in oligohydramnios. Aim and objective were to study obstetric risk factors associated with oligohydramnios and maternal outcome in the form of mode of delivery, and to assess neonatal complications in terms of APGAR score at birth, NICU admission rates, meconium stained liquor and still birth rates.Methods: It was an Observational, Prospective, clinical study of 100 pregnant patients diagnosed with oligohydramnios by ultrasound, carried out in Geetanjali medical college and hospital, Udaipur for period of from January 2020-August 2020. The study was conducted after ethical clearance and with informed consent. Detailed history on demographic profile, medical illness, obstetric history and antenatal complication if any in the present pregnancy; general examination, obstetric examination and bimanual examination were performed meticulously.Results: In our study 53% cases of oligohydramnios were associated with some of the risk factors like PIH (29%), IUGR (22%), fetal anomaly (1%), systemic maternal disease (1%) and 47% of the cases were Idiopathic. LSCS was done in 85.71% cases with AFI<5 cm. Low birth weight was found in 51.43% cases with AFI<5 cm. NICU admission was required for 28.57% cases with AFI<5 cm.Conclusions: AFI is an important and convenient screening test for prediction of perinatal outcome. In presence of oligohydramnios, the risk of fetal distress, operative delivery, low Apgar score, low birth weight, perinatal morbidity and mortality are more. Hence early detection of oligohydramnios, associated antenatal risk factors and timely management can improve the maternal and fetal outcome.

scholarly journals Characteristics of PPROM in General Hospital Dr. Soetomo Surabaya Period September 2017 to September 2019

2021 ◽  
Vol 2 (2) ◽  
pp. 81-87
Author(s):  
Letizia Alessandrini ◽  
Budi Wicaksono
Keyword(s):  
Vaginal Delivery ◽  
Gestational Age ◽  
Perinatal Care ◽  
Breech Presentation ◽  
Fetal Distress ◽  
Morbidity And Mortality ◽  
Perinatal Morbidity ◽  
Lung Maturation ◽  
Exclusion Criteria ◽  
Type Of Delivery

Background: Preterm Prelabour Rupture of Membranes (PPROM) is one of the causes of perinatal morbidity and mortality. Objective: To find out the characteristic of PPROM in Dr. Soetomo Hospital in September 2018 to September 2019. Method: A Retrospective Descriptive Study. The data came from the medical records of patients with PPROM who were included in the inclusion criteria. The exclusion criteria is all PPROM cases at Gestational age > 34 weeks. Result: The incidence of PPROM during September 2017 to September 2019 was 6.8% (175 patients), of which 152 patients included NBC cases and 23 patients with BC cases. Primipara 76 patients and Multipara 99 patients. For gestational age <26 weeks it was 17.1%, 26-30 weeks 29.7% and 31-34 weeks 53.1%. In this study, PPROM was amused 23.6%, underweight 3.1%, HBsAg 7.5%, HIV 7%, anemia 10.3%, Obesity 5.2%, Pragestational Diabetes 7.4%, Gestational Diabetes. 2,6%, preeclampsia 7,9% and severe preeclampsia 2,2%. The distribution of PPROM patients who received lung maturation was 72%, while the remaining 28% did not get lung maturation. Type of delivery for PPROM cases was vaginal delivery as much as 60% while 40% for cesarean section. Indications for vaginal delivery include fetal distress 25%, abnormal NST 18%, gemeli 17%, BSC 12%, febris 10%, pulmonary edema 5% and breech presentation 5%. The outcome distribution of PPROM infants born with asphyxia at birth was 87%. Weight of babies born with PPROM> 2500 g 4%, 1000-2500 g 73% and <1000 g 23%. The condition of the babies at birth with spontaneous breathing was 36 babies, nasal O2 was 13 babies and CPAP was 70 babies. The causes of death for preterm KPP babies included RDS 9 babies, Sepsis 4 babies and severe asphyxia 19 babies. The length of NICU care for infants who died with KPP Preterm mothers was <24 hours for 15 babies, 1-3 days 13 babies, 4-7 days 3 babies,> 7 days 3 babies and 5 fetuses were IUFD. 12 patients with PPROM received amnioinfusion while 5 patients with amniopatch, Outcome of infants from conservative PPROM who were treated with amniopatch or amnioinfusion obtained 6 babies died at birth, 8 babies with CPAP breath support, 1 baby with PCV breath support, 1 baby with ventilator and 1 infant spontaneously breathed. A total of 3 babies were outpatient after treatment for a maximum of ± 25 days. Conclusion: Perinatal care is currently experiencing some rapid progress, but the case of PPROM is still one of the biggest contributors to perinatal morbidity and mortality.

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