Breech Presentation: Vaginal Delivery or Caesarean Section?

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

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Breech Presentation: Vaginal Delivery or Caesarean Section?

European Journal of Interdisciplinary Studies ◽

10.26417/ejis.v4i1.p153-157 ◽

2016 ◽

Vol 4 (1) ◽

pp. 153

Author(s):

Tomescu Cezar Laurentiu ◽

Rodica Sîrbu ◽

Emin Cadar ◽

Brezeanu Dragos ◽

Aneta Tomescu

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Vaginal Delivery ◽

Total Population ◽

Population Sample ◽

Breech Presentation ◽

Current Paper ◽

Clinical Hospital ◽

Obstetrics And Gynaecology ◽

Number Of Patients

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A STUDY OF POSTPARTUM INTRAUTERINE CONTRACEPTIVE DEVICE INSERTIONS IN CAESAREAN SECTIONS AND FOLLOWING VAGINAL DELIVERIES

10.36106/ijsr/8922651 ◽

2021 ◽

pp. 1-3

Author(s):

Shweta Pathak ◽

Manaswita Samanta ◽

Debarshi Jana

Keyword(s):

Caesarean Section ◽

Prospective Study ◽

Clinical Outcomes ◽

Vaginal Delivery ◽

Caesarean Delivery ◽

Contraceptive Device ◽

Obstetrics And Gynaecology ◽

Vaginal Deliveries ◽

Intrauterine Contraceptive

Aim: To study clinical outcomes of immediate postpartum IUCD insertion and to compare immediate postpartum IUCD insertion as a factor of route of insertion (caesarean vs. vaginal). Material and methods: This prospective study was conducted in a Department of Obstetrics and Gynaecology, College of medicine and JNM Hospital, Kalyani, Nadia. Duration of the study was one and half years [ 15 months inclusion, 3 months follow up]. Total 100 cases are included [50 vaginal and 50 caesarean]. Women who were attending or referred to OPD or ER of Dept. of Obst and Gynae, College of medicine and JNM Hospital and delivering either vaginally or by caesarean section, have received counseling for postoperative contraception and have consented to PPIUCD insertion Result:It was found that in Caesarean, 26(52.0%) patients had bleeding P/V 6 weeks. In Vaiginal, 28(56.0%) patients had bleeding P/V 6 weeks. Association of bleeding P/V 6 weeks vs. group was not statistically signicant (p=0.61968). In Caesarean, 11(22.0%) patients had bleeding P/V 3 weeks. In Vaiginal, 13(26.0%) patients had bleeding P/V 3 weeks. Association of bleeding P/V 3 weeks vs. group was not statistically signicant (p=0.6395). Conclusion:Infection was not statistically signicant in two groups at 6 week and 3 month.Missing thread was signicantly higher caesarean delivery compared to vaginal delivery.It was also found that refusal/ continuation was more common in vaginal delivery compared to caesarean delivery, which was not statistically signicant.

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Singleton term breech presentation: planned vaginal delivery vs elective caesarean section at Aminu Kano Teaching Hospital

Sri Lanka Journal of Obstetrics and Gynaecology ◽

10.4038/sljog.v34i2.4826 ◽

2012 ◽

Vol 34 (2) ◽

pp. 45

Author(s):

Omole-Ohonsi Abiodun ◽

Umoru Joseph ◽

Aiyedun Tajudeen

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Teaching Hospital ◽

Elective Caesarean Section ◽

Breech Presentation

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Vaginal Delivery versus Elective Caesarean Section for Breech Presentation - Experience in Institute of Child and Mother Health (ICMH)

Medicine Today ◽

10.3329/medtoday.v31i1.40317 ◽

2019 ◽

Vol 31 (1) ◽

pp. 23-26

Author(s):

Mahe Jabeen ◽

Sabiha Shimul ◽

Ummay Salma ◽

Jebunnesa

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Maternal Morbidity ◽

Neonatal Outcome ◽

Elective Caesarean Section ◽

Tertiary Care ◽

Mode Of Delivery ◽

Breech Presentation ◽

Cost Of Care ◽

Increased Risk

Introduction: Compared with a fetus with cephalic presentation, a breech fetus faces increased risk during labour and delivery of asphyxia from cord compression and of traumatic injury during delivery of the shoulders and head. Caesarean section avoids most of this risk. The purpose of this study was to evaluate the feasibility of vaginal delivery of uncomplicated singleton breech presentation by evaluating early neonatal morbidity and mortality as well as maternal morbidity following vaginal and caesarean delivery for breech presentation. Materials and Methods: This is a cross sectional comparative study.104 women with singleton breech presentation at term in labour were included consequetively in labour ward of Institute of Child and Mother Health (ICMH). Informed consent was taken from them. Neonatal and maternal outcome were recorded and statistical analysis was done using SPSS version 22. Results: APGAR at 5 min and Neonatal Intensive Care Unite (NICU) admission were not affected by mode of delivery. Long term neonatal outcome is similar in either mode of delivery. Maternal morbidity and duration of hospital stay is increased in caesarean births. Conclusion: Neonatal outcome did not depend on mode of delivery though maternal morbidity and cost of care is increased following Caesarean Section. Proper selection of cases and by improving skill & confidence in new generation obstetrician, vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to a woman in a tertiary care centre. Medicine Today 2019 Vol.31(1): 23-26

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Maternal and neonatal outcomes for the gentle caesarean section in breech presentation

British Journal of Midwifery ◽

10.12968/bjom.2020.28.9.660 ◽

2020 ◽

Vol 28 (9) ◽

pp. 660-664

Author(s):

Christa H Brethouwer ◽

Sicco A Scherjon ◽

Ayten Elvan-Taşpinar

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Neonatal Outcome ◽

Breech Presentation ◽

Neonatal Outcomes ◽

Chi Square ◽

Significant Difference ◽

Mother And Child ◽

Maternal And Neonatal Outcomes ◽

Clinically Significant

Background The gentle caesarean section (GCS) is an alternative to the conventional caesarean section. It aims to optimise the wellbeing of mother and child by mimicking certain aspects of a vaginal delivery when a caesarean section is indicated. Aim To compare the maternal and neonatal outcomes of a GCS in cephalic and breech presentation. Methods In this retrospective study, the outcomes of 180 women who underwent a GCS were analysed, where 120 fetuses were in cephalic and 60 were in breech position. Comparisons were made using Chi-square, Mann-Whitney U and t-tests. Maternal and neonatal outcomes were analysed. Results Apgar 1 was significantly lower for breech position (P=0.019). The Apgar 5 and 10 showed no difference. Neonatal temperature was slightly lower in breech position (36.8°C ± 0.36 versus 36.9°C ± 0.39, P=0.046). Birthweight was significantly lower for breech position (P=0.009). Blood loss was significantly higher in cephalic position (441 ± 230 versus 353 ± 151, P=0.002). Conclusions When performing a GCS, there is no clinically significant difference in maternal or neonatal outcome between a cephalic and a breech presentation. It seems safe to perform a GCS for breech presentation.

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Indicators for mode of delivery in pregnant women with uteruses scarred by prior caesarean section: a retrospective study of 679 pregnant women

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2604-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Zhifen Hua ◽

Fadwa El Oualja

Keyword(s):

Retrospective Study ◽

Caesarean Section ◽

Pregnant Women ◽

Vaginal Delivery ◽

Gestational Age ◽

Placenta Previa ◽

Mode Of Delivery ◽

Fetal Membrane ◽

Delivery Mode ◽

Maternal Preference

Abstract Background The delivery mode for pregnant women with uteruses scarred by prior caesarean section (CS) is a controversial issue, even though the CS rate has risen in the past 20 years. We performed this retrospective study to identify the factors associated with preference for CS or vaginal birth after CS (VBAC). Methods Pregnant women (n = 679) with scarred uteruses from Moulay Ali Cherif Provincial Hospital, Rashidiya, Morocco, were enrolled. Gestational age, comorbidity, fetal position, gravidity and parity, abnormal amniotic fluid, macrosomia, placenta previa or abruptio, abnormal fetal presentation, premature rupture of fetal membrane with labor failure, poor progression in delivery, and fetal outcomes were recorded. Results Out of 679 pregnant women ≥28 gestational weeks, 351 (51.69%) had a preference for CS. Pregnant women showed preference for CS if they were older (95% CI 1.010–1.097), had higher gestational age (95% CI 1.024–1.286), and a shorter period had passed since the last CS (95% CI 0.842–0.992). Prior gravidity (95% CI 0.638–1.166), parity (95% CI 0.453–1.235), vaginal delivery history (95% CI 0.717–1.818), and birth weight (95% CI 1.000–1.001) did not influence CS preference. In comparison with fetal preference, maternal preference was the prior indicator for CS. Correlation analysis showed that pregnant women with longer intervals since the last CS and history of gravidity, parity, and vaginal delivery showed good progress in the first and second stages of vaginal delivery. Conclusions We concluded that maternal and gestational age and interval since the last CS promoted CS preference among pregnant women with scarred uteruses.

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Case of successfully delivered dicavitary twins in uterus didelphus

BMJ Case Reports ◽

10.1136/bcr-2021-245139 ◽

2021 ◽

Vol 14 (11) ◽

pp. e245139

Author(s):

Ellie Barnes ◽

Kate Walker ◽

Hazem Mohamed Sayed ◽

Amanda Green

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Congenital Abnormality ◽

Breech Presentation ◽

Vaginal Birth ◽

Obstetric Complications ◽

Mullerian Ducts ◽

Longitudinal Septum

Uterus didelphus is a congenital abnormality arising from failure of fusion of Mullerian ducts, creating two separate uterine horns, two cervices and, in some cases, a vagina divided by a longitudinal septum. In this case, a 26-year-old woman with previously undiagnosed uterus didelphus spontaneously conceived dicavitary twins. Although initially wanting a vaginal birth, when both twins were in a breech presentation, a caesarean section was performed at 36 weeks, delivering two healthy babies. We will discuss the risk of obstetric complications in uterus didelphus and the challenges surrounding a vaginal delivery.

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Postverta, Agrippa, Caesarea

10.1093/med/9780198854807.003.0009 ◽

2021 ◽

pp. 57-62

Author(s):

Michael Obladen

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Middle Ages ◽

Caesarean Delivery ◽

Compression Fracture ◽

Cerebral Haemorrhage ◽

Breech Presentation ◽

Population Based ◽

Cord Prolapse ◽

Dead Infant

The frequency of breech presentation at term is 3% among singletons. Greek physicians dreaded those births, as they frequently led to the death of mother, infant, or both. In Rome, surviving infants were named Agrippa (born with difficulty), and the goddess Postverta was revered for presiding over breech deliveries. To the antique procedures of embryotomy and hook for the dead infant, the Middle Ages added manoeuvres to turn and extract a living, albeit often traumatized infant. These manoeuvres were associated with asphyxia from cord prolapse or compression, fracture of legs, arms, or clavicles, cerebral haemorrhage, trauma to the cerebellum, tentorium, or pituitary stalk, and with torticollis and arm plexus palsy. The prototype of difficult birth, infants born feet-first were considered dangerous, and were neglected or killed in many cultures. Even after Caesarean section had lost most of its risk, conservative obstetricians still propagated vaginal delivery from breech presentation. Finally, at the beginning of the 21st century, large randomized trials and population-based studies proved that Caesarean delivery was safe for the mother and highly beneficial for the child, making vaginal delivery from breech presentation obsolete.

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Maternal endometrial oedema may increase perinatal mortality of cloned and transgenic piglets

Reproduction Fertility and Development ◽

10.1071/rd10220 ◽

2011 ◽

Vol 23 (5) ◽

pp. 645 ◽

Cited By ~ 11

Author(s):

M. Schmidt ◽

K. D. Winter ◽

V. Dantzer ◽

J. Li ◽

P. M. Kragh ◽

...

Keyword(s):

Small Intestine ◽

Retrospective Study ◽

Caesarean Section ◽

Perinatal Mortality ◽

Vaginal Delivery ◽

Relative Weight ◽

Gestation Length ◽

Large White ◽

Organ Weights ◽

Piglet Mortality

The perinatal mortality of cloned animals is a well-known problem. In the present retrospective study, we report on mortality of cloned transgenic or non-transgenic piglets produced as part of several investigations. Large White (LW) sows (n = 105) received hand-made cloned LW or minipig blastocysts and delivered either spontaneously or after prostaglandin induction followed by either Caesarean section or vaginal birth. The overall pregnancy rate was 62%, with 26% of pregnancies terminating before term. This resulted in 48 deliveries. The terminated pregnancies consisted of 12 abortions that occurred at 35 ± 2 days gestation and five sows that went to term without returning to heat and then by surgery showed the uterus without fetal content. The gestation length was for sows with LW piglets that delivered by Caesarean section or vaginally was 115.7 ± 0.3 and 117.6 ± 0.4 days, respectively. In sows with minipiglets, the gestation length for those delivered by Caesarean section or vaginally 114.4 ± 0.2 and 115.5 ± 0.3 days, respectively. Of the 34 sows that delivered vaginally, 28 gave birth after induction, whereas 6 farrowed spontaneously. Of the 14 sows that delivered after Caesarean section and in the five empty sows, the endometrium and placenta showed severe oedema. Piglet mortality following vaginal delivery was higher than after Caesarean section (31% v. 10%, respectively; P < 0.001). When vaginal delivery occurred spontaneously, the stillborn rate was greater than after induced delivery (56% v. 24%, respectively; P < 0.0001). Internal organ weights were recorded for seven cloned LW piglets and six normal piglets. The relative weight of the heart, liver, kidneys and small intestine was found to be reduced in the cloned piglets (P < 0.05). The present study demonstrates extensive endometrial oedema in sows pregnant with cloned and transgenic piglets, as well as in empty recipients, at term. The growth of certain organs in some of the cloned piglets was reduced and the rate of stillborn piglets was greater in cloned and transgenic piglets delivered vaginally, possibly because of oedema of the fetal–maternal interface.

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Comparison of clinical outcomes following CuT-380A insertion in postplacental period with interval insertion

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174071 ◽

2017 ◽

Vol 6 (9) ◽

pp. 4111

Author(s):

Divya Chauhan ◽

Shalini Gainder

Keyword(s):

Caesarean Section ◽

Vaginal Delivery ◽

Mode Of Delivery ◽

Abnormal Uterine Bleeding ◽

Complication Rates ◽

Expulsion Rate ◽

Interval Group ◽

Obstetrics And Gynaecology ◽

Significant Difference ◽

A Prospective Study

Background: Postplacental intra-uterine device has many benefits like providing contraception immediately after childbirth, non-interference with lactation and high efficacy. However, concerns about its safety have led to decreased use of this method of contraception. Hence, this study aims to compare the complication rates following insertion of immediate postplacental IUCD (PPIUCD) with interval insertion.Methods: This is a prospective study conducted under the Department of Obstetrics and Gynaecology in PGIMER, Chandigarh. 196 women were included in the study. Women were divided in two groups, those who were inserted with immediate postplacental IUCD versus those who had IUCD insertion in interval period. The two groups were followed up for a period of 6 months and complications were recorded. The PPIUCD group was further subdivided into 2 subgroups based on mode of delivery, vaginal delivery and caesarean section. These PPIUCD subgroups were also compared.Results: There was no statistically significant difference in the incidence of pelvic pain, infection, abnormal uterine bleeding and expulsion between the PPIUCD and interval group. However, when the PPIUCD subgroups were compared, it was seen that no woman in caesarean section subgroup had expulsion of IUCD whereas 9.8% women had expulsion in the vaginal delivery PPIUCD subgroup.Conclusions: Postplacental and interval IUCD seem to be comparable for the incidence of various complications. However, intra-caesarean PPIUCD insertion seems to have a much lower expulsion rate as compared to vaginal delivery PPIUCD insertion.

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