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Journal articles on the topic 'Breech delivery'

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Published: 4 June 2021
Last updated: 29 July 2024

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1

Gibson, D. H. "Breech delivery." Journal of Obstetrics and Gynaecology 10, no. 6 (January 1990): 506–9. http://dx.doi.org/10.3109/01443619009151255.

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2

Mukhopadhyay, Sambit, and Sabaratnam Arulkumaran. "Breech delivery." Best Practice & Research Clinical Obstetrics & Gynaecology 16, no. 1 (February 2002): 31–42. http://dx.doi.org/10.1053/beog.2001.0253.

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3

Chaudhary, Rajendra Kumar, Rajan Ghimire, and Deepak Raj Kafle. "Perinatal Outcome of Vaginal Breech Delivery versus Caesarean Breech Delivery in a Tertiary Care Center." Journal of Nepal Medical Association 56, no. 212 (August 31, 2018): 796–99. http://dx.doi.org/10.31729/jnma.3697.

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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.
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4

TAHIRA MALIK and MAHWISH NAJAM. "BREECH PRESENTATION: AN OVERVIEW OF PATIENTS VISITING SOUTHERAN PUNJAB." Pakistan Postgraduate Medical Journal 26, no. 3 (June 1, 2015): 81–83. http://dx.doi.org/10.51642/ppmj.v26i3.147.

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Objective: This study was conducted to determine incidence of breech presentation, etiology, mode of delivery and fetal outcome. Methodology: Retrospective cohort study was conducted in Sheikh Zayed Medical hospital, Rahim Yar Khan from period of January 2013 to December 2015. 685 patients with breech presentation in Southern Punjab were included in our study. Demographic data like age, parity, gestational age and previous mode of delivery was determined. Type of breech presentation was checked by ultrasonography. Etiology was determined for breech presentation. Mode of delivery in present pregnancy was determined in the form of vaginal delivery and cesarean section. Fetal outcome was compared in both groups. Results: Incidence of extended breech was higher 98.9%, where flexed breech was in 6.5% and footling breech was in 3.5% of cases. Most of cases with breech presentation was in primigravida (303) 44.2%, 277 (40%) were multi and grand multiparous, 8.6% with preterm breech, 28 women(4%) breech presentation was found in first twin, fetal anomalies were in 1.45%, uterine anomalies in cases and placenta previa in 03 patients. 173 (25.2%) were delivered by vaginal breech delivery and 512 (74.7%) were delivered by lower segment cesarean section. Perinatal morbidity and mortality was lower in cesarean section group as compared to vaginal delivery group. But statistically there was no significant difference. Conclusion: Proper selection of patient for mode of delivery will be helpful in improving fetomaternal outcome. Regular drills in maternity units will enhance expertise and in the presence of skilled personals vaginal breech delivery will be safe mode of delivery.
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Karning, Rashmi Kumar, Bhanu B. T., and Sarojini. "Mode of delivery and outcome of breech presentation: a prospective observational study in a tertiary centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 8 (July 26, 2017): 3409. http://dx.doi.org/10.18203/2320-1770.ijrcog20173453.

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Background: Breech presentation is the commonest malpresentation with the incidence of 3-4% at term. This study was done with the objective of studying the mode of delivery in breech presentation and to compare the maternal and fetal outcome in patients delivered vaginally to those delivered by cesarean section.Methods: This prospective observational study was conducted in Vanivilas Hospital, affiliated to Bangalore Medical College and Research Institute, from June 2014 to May 2015. The study group included 509 patients with breech presentation who were studied with respect to their gestational age, birth weight, type of breech, mode of delivery, maternal and perinatal outcome.Results: The incidence of breech presentation was 2.92% (509) among 17454 total deliveries with the incidence of 3.17% in primi and 2.73% in multies. 193 (38%) patients had vaginal breech delivery and 316 (62%) delivered by LSCS. Apgar score of less than 7 at 1 minute was seen with 21.42% of vaginally delivered fetuses and 9.09% of fetuses delivered by cesarean section. The perinatal mortality was 1.6% (8 cases) in vaginal group 0.8% (4 cases) in LSCS group. The short term maternal complications in LSCS group was 7.62% and in vaginal delivery group was 3.09%.Conclusions: The short term maternal morbidity is higher in patients with cesarean section compared to those with vaginal breech delivery. Perinatal outcome is better in babies delivered by cesarean section. Still vaginal breech delivery can be an option for breech babies with proper selection and when conducted by a skilled obstetrician.
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6

Naz, Samina. "VAGINAL BREECH DELIVERY." Professional Medical Journal 22, no. 08 (August 10, 2015): 1024–28. http://dx.doi.org/10.29309/tpmj/2015.22.08.1149.

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Objective: To determine the obstetric and perinatal outcome of pregnancieswith singleton breech presentation, and to scrutinize the causes of increasing incidence ofcesarean section in breech presentation. Design: Analytical Observational study. Place andduration: Department of obstetrics and gynecology Fatima hospital Baqai university campusfrom Jan 2010 to Oct 2011. Patients & Methods: This study includes 135 patients with singletonbreech presentation ≥ 34 weeks of gestation, were analyzed in detail with help of designedperforma. Patients were categorized in three groups. Groups a, who had elective C-section,group b. who underwent emergency caesarean section or had C-section after failed trial ofvaginal delivery and group c. who had vaginal breech delivery. Elective caesarean section wasdone in those cases that had some other indications for carrying out this procedure apart frombreech presentation. Trial of vaginal breech delivery was planned for all multiparous womenexcept those falling in group A. All antepartum fetal demise, twin pregnancies and placentaprevia of major degree were excluded. Results: Of 135 women, 7(5%) underwent prelabourcesarean, and 128(95%), had trial of vaginal delivery, of whom 117(91.5%) delivered vaginally.Significantly more infants weighing> 3.5kg were selected for prelabour and intrapartumcesarean than vaginal delivery. Two neonates had Apgar score< 7 at 5 minutes but both werenormal neurologically. There were no nonanomalous perinatal death and no case of significanttrauma or neurological dysfunction. Two infants died due to lethal anomalies. Conclusion:Trial of vaginal breech delivery in well counselled patients, still taken as an appropriate optionwithout compromising prenatal and maternal outcome. It also decreases the rate of cesareansection.
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7

Biswas, A., and M. J. Johnstone. "Term Breech Delivery." Obstetrical & Gynecological Survey 49, no. 2 (February 1994): 93–94. http://dx.doi.org/10.1097/00006254-199402000-00008.

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8

Escamilla, J. O. "Breech delivery protocol." American Journal of Obstetrics and Gynecology 178, no. 5 (May 1998): 1104. http://dx.doi.org/10.1016/s0002-9378(98)70567-8.

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9

HERBST, ANDREAS, and KARIN KÄLLÉN. "TERM BREECH DELIVERY." Fetal and Maternal Medicine Review 16, no. 4 (November 2005): 289–322. http://dx.doi.org/10.1017/s0965539505001634.

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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.
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10

Schiff, E. "Singleton Breech Delivery." ACOG Clinical Review 2, no. 2 (March 4, 1997): 6. http://dx.doi.org/10.1016/s1085-6862(97)81014-x.

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11

Airao, Bhavesh B., Vishal M. Sharma, Ravi A. Zala, and Vimal Vasava. "Fetomaternal outcome in breech delivery." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 6 (May 26, 2018): 2480. http://dx.doi.org/10.18203/2320-1770.ijrcog20182372.

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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.
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12

Mohanraj, Uma, and A. Adhirai. "Study of fetomaternal outcome in various modes of breech delivery in a tertiary care hospital- MGM GH, Trichy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 1 (December 26, 2020): 154. http://dx.doi.org/10.18203/2320-1770.ijrcog20205761.

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Background: Aim of the study was to optimize the fetomaternal outcome using different modes of delivery in breech presentation and objective of the study was to optimize the maternal and perinatal outcome in various modes of breech delivery.Methods: Among 150 mothers with different parity and gestational age having singleton breech were studied during May 2019- October 2019 for the period of 6 months at KAPV government medical college. Fetomaternal outcome was compared in various modes of breech delivery during this study period in our institute. This study was a prospective analytical study.Results: Incidence of breech presentation was 3.3% of total deliveries in this institute. Around 4 (26.6%) cases by emergency LSCS, 48 (32%) cases delivered vaginally, 62 (41.3%) cases by elective LSCS. Comparatively, large number of cases were delivered by planned caesarean section in our institute. The maternal and perinatal morbidity and mortality was found to be less in planned caesarean section compared with other modes of delivery in this study.Conclusions: In view of insignificant difference in the fetomaternal outcome balanced decision about mode of delivery on a case by case basis will go a long way in improving both fetal and maternal outcome. Regular drills and conduct of assisted vaginal breech delivery should be pursued in all maternity hospitals.
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Tamrakar, Renuka, Deekshanta Sitaula, Basant Sharma, Bandana Pokharel, Dhan Khatri, and Sandip Pokharel. "PERINATAL OUTCOMES OF SINGLETON BREECH DELIVERIES IN A TERTIARY CARE CENTRE IN NEPAL." Journal of Chitwan Medical College 11, no. 3 (September 30, 2021): 68–71. http://dx.doi.org/10.54530/jcmc.421.

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Background: Breech presentation has been associated with higher rates of perinatal morbidity irrespective of mode of delivery. The aim of this study was to determine the prevalence and perinatal outcomes of singleton breech deliveries at Chitwan Medical College, a tertiary level hospital in Nepal. Methods: A retrospective review of records of all women who delivered at Chitwan Medical College with breech presentation from September 2018 to October 2020 was conducted. Information on demographic variables, obstetric characteristics and perinatal outcomes were obtained, recorded and analyzed. Results: Out of 6712 cases of deliveries during the study period, 226 had breech presentation with prevalence of 3.37%. One hundred ninety-one (84.5%) of them had undergone Caesarean delivery with 125 (65.4%) emergency and 66 (34.6%) elective Caesarean delivery. More than two third (70.4%) of breech deliveries were term deliveries while 28.8% were preterm. There were 2 cases of still births and 1 neonatal death with Perinatal Mortality Rate of 13.27 per 1000 breech deliveries. Vaginal breech delivery was associated with higher perinatal mortality, low Apgar score and low birth weight. Caesarean breech delivery was associated with increased rates of Neonatal Intensive Care Unit admission. Conclusions: The neonatal mortality and morbidity were higher with the vaginal breech deliveries. However further studies with larger sample size and greater statistical power is necessary to draw definitive conclusion.
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Bibi, Safia, Khanda Gul, Fozia Mohammad Bukhsh, and Palwasha Gul. "Assessment Of Perinatal Outcome Of Breech Presentation At A Tertiary Care Hospital, Quetta." Journal of Bahria University Medical and Dental College 09, no. 03 (September 4, 2019): 218–21. http://dx.doi.org/10.51985/jbumdc2018098.

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Objective: To review the mode of delivery and perinatal outcome in breech presentation in a tertiary care hospital. Study Design and Setting: Retrospective Analytical Study. Department of Obstetrics and Gynecology Unit-4, Bolan Medical Complex Hospital, Quetta, from 1st January 2012 to 31st December, 2016. Methodology: This retrospective analytical study included review of clinical records of all patients who delivered either vaginally or via caesarean section with breech presentation. Results: During the study period, 806 patients presented with breech (2.4%). Vaginal breech delivery was carried out in 71.8% patients and caesarean section was done in 28.2% patients. In vaginal breech group 30.7% patients were primigravida and 69.3% patients were multigravida. In caesarean section group 50.3% patients were primigravida and 49.7% were multigravida. Most common birth weight was between 2.5-3.5 kg in both group. Most common indication for cesarean section was breech with previous one LSCS. Conclusion: Like all vaginal births, vaginal breech delivery is not only beneficial in the chance of having a vaginal birth in future but also prevents from the complications of caesarean delivery.
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Kothapally, Kavitha, Archana Uppu, and Vijayalakshmi Gillella. "Study of the obstetric outcome of breech presentation in pregnancy in a tertiary hospital in a rural area in Telangana, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 5 (April 27, 2017): 2040. http://dx.doi.org/10.18203/2320-1770.ijrcog20171973.

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Background: The present study was undertaken to study the incidence, aetiology and obstetric outcome of breech presentation in pregnancy in a teaching hospital in a rural area.Methods: The present retrospective observational study was conducted in the department of obstetrics and gynaecology at Bhaskar Medical College and Bhaskar General Hospital, Yenkepally, Telangana from May 2014 to March 2017. 50 cases of breech presentation were included in the study. Demographic data like age, parity, gestational age of first detection of breech, aetiological factors of breech, mode of delivery, neonatal outcome were noted from case records.Results: The incidence of breech was 1.4% in pregnancies attending Bhaskar general hospital. 74% were in the age group of 20-24yrs & 20% were in the age group of 25-29yrs. Primis accounted for 62% of the study group. Common etiologies of breech presentation were oligohydramnios (28%) and uterine anomalies (28%). No obvious fetal anomalies were noted. Majority (96%) of cases were delivered by caesarean section for breech associated with oligohydramnios, gestational hypertension, intrauterine fetal growth restriction and preterm. Neonatal outcome was good in breech delivered by caesarean section.Conclusions: Breech delivery is a high risk pregnancy with adverse fetal outcomes during pregnancy and labour. Though caesarean section for breech presentation is not universally recommended, caesarean section can reduce the perinatal mortality and morbidity compared to vaginal birth for term breech pregnancy. Mode of delivery should be decided based on the case and obstetrician’s skill.
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Kaul, Somika, and Bijal D. Rami. "A prospective observational study of breech pregnancy in a tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 2 (January 28, 2020): 688. http://dx.doi.org/10.18203/2320-1770.ijrcog20200359.

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Background: Breech presentation is the commonest of all mal presentations. Vaginal delivery of breech presentation at term is associated with a much higher perinatal mortality and morbidity than that of vertex presentation.Methods: This prospective study was carried out in the department of obstetrics and gynaecology, S. S. G. Hospital, Baroda for a period of six months from 1st May 2019 to 31st October 2019. Out of a total number of 4476 deliveries, 159 were breech pregnancy. It included all the women admitted in labour room or ward who delivered with clinical or ultrasound diagnosis of breech presentation after 20 weeks of gestation.Results: In the present study incidence of breech pregnancy was 3.6%. Authors observed the highest incidence of breech pregnancy in the age group of 20 to 25 years. Maximum (62.9%) cases delivered after 37 weeks of gestation. In our study 62.3% cases were primigravida and 37.7% were multigravida. Majority of cases (77.4%) delivered by caesarean section. Among all the babies born 50.6% were having birth weight of less than 2.5 kg.Conclusions: Authors need to study and analyse all cases of breech pregnancy individually to decide the management and mode of delivery depending on cases to case basis and expertise of the staff available. Delivery of breech foetus should be conducted by experience obstetrician after appropriate consent from pregnant women and her relatives.
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Wanjari, Sanjivani. "Breech delivery: changing scenario." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 4, no. 2 (2015): 384. http://dx.doi.org/10.5455/2320-1770.ijrcog20150419.

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18

Porter, R. "Breech delivery: the dilemma." BJOG: An International Journal of Obstetrics and Gynaecology 113, no. 8 (August 2006): 973–74. http://dx.doi.org/10.1111/j.1471-0528.2006.00996.x.

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19

Mostello, D., J. J. Chang, F. Bai, J. Wang, C. Guild, K. Stamps, and T. L. Leet. "Breech Presentation at Delivery." Obstetrical & Gynecological Survey 69, no. 5 (May 2014): 241–43. http://dx.doi.org/10.1097/01.ogx.0000450111.48857.c5.

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20

Caning, Malene Mie, Steen Christian Rasmussen, and Lone Krebs. "Maternal outcomes of planned mode of delivery for term breech in nulliparous women." PLOS ONE 19, no. 4 (April 3, 2024): e0297971. http://dx.doi.org/10.1371/journal.pone.0297971.

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Objective To estimate short- and long-term maternal complications in relation to planned mode of term breech delivery in first pregnancy. Design Register-based cohort study Setting Denmark Population Nulliparous women with singleton breech delivery at term between 1991 and 2018 (n = 30,778). Methods We used data from the Danish national health registries to identify nulliparous women with singleton breech presentation at term and their subsequent pregnancies. We performed logistic regression to compare the risks of maternal complications by planned mode of delivery. All data were proceeded and statistical analyses were performed in SAS 9.4 (SAS Institute Inc. Cary, NC, USA). Main outcome measures Postpartum hemorrhage, operative complications, puerperal infections in first pregnancy and uterine rupture, placenta previa, post-partum hemorrhage, hysterectomy and stillbirth in the subsequent two pregnancies. Results We identified 19,187 with planned cesarean and 9,681 with planned vaginal breech delivery of which 2,970 (30.7%) delivered vaginally. Planned cesarean significantly reduced the risk of postoperative infections (2.4% vs 3.9% adjusted odds ratio (aOR): 0.54 95% confidence interval (CI) 0.44–0.66) and surgical organ lesions (0.06% vs 0.1%; (aOR): 0.29 95% CI 0.11–0.76) compared to planned vaginal breech delivery. Planned cesarean delivery in the first pregnancy was associated with a significantly higher risk of uterine rupture in the subsequent pregnancies but not with risk of postpartum hemorrhage, placenta previa, hysterectomy, or stillbirth. Conclusion Compared to planned vaginal breech delivery at term, nulliparous women with planned cesarean breech delivery have a significantly reduced risk of postoperative complications but a higher risk of uterine rupture in their subsequent pregnancies.
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Shrestha, Buddhi Kumar, and Subha Shrestha. "Comparison of Perinatal Outcome of Breech Presentation between Vaginal Delivery and Cesarean Section." Journal of Lumbini Medical College 4, no. 1 (June 30, 2016): 4. http://dx.doi.org/10.22502/jlmc.v4i1.87.

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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.
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Pierre, Clémentine, Audrey Leroy, Adeline Pierache, Laurent Storme, Véronique Debarge, Sandrine Depret, Thameur Rakza, Charles Garabedian, and Damien Subtil. "Is vaginal delivery of a fetus in breech presentation at an extremely preterm gestational age associated with an increased risk of neonatal death? A comparative study." PLOS ONE 16, no. 10 (October 20, 2021): e0258303. http://dx.doi.org/10.1371/journal.pone.0258303.

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Background The effect on neonatal mortality of mode of delivery of a fetus in breech presentation at an extremely preterm gestational age remains controversial. Objective To compare mortality associated with planned vaginal delivery (PVD) of fetuses in breech presentation with that of fetuses in breech presentation with a planned cesarean delivery (PCD). Material and methods Retrospective study reviewing records over a 19-year period in a level 3 university referral center of singleton infants born between 25+0 and 27+6 weeks of gestation, alive on arrival in the delivery room, and weighing at least 500 grams at birth. Infants in the first group were in breech presentation with PVD and the second in breech presentation with PCD. The principal endpoint was neonatal death. Results During the study period, we observed 113 breech presentations with PVD, and 80 breech presentations with PCD. Although not significant after adjustment, neonatal mortality in the breech PVD group was more than twice that of the breech PCD group (19.5 vs 7.8%, P = 0.031, ORa = 2.6, 95% CI 0.8–9.3, NNT = 8). This higher neonatal mortality in the breech PVD group was exclusively associated with a higher risk of death in the delivery room (12.4 vs 0.0% P = 0.001, OR not calculable, NNT = 8). In these extremely preterm breech presentations with PVD, neonatal mortality in the delivery room was associated with entrapment of the aftercoming head, cord prolapse, and a short duration of labor. Conclusion For deliveries between 25+0 and 27+6 weeks’ gestation, vaginal delivery in breech presentation is associated with a higher risk of death in the delivery room.
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Sharma, Rohit, Sahil Singla, Rajan Sharma, Ranbir S. Bawa, Arshpreet Singh, Navpreet S. Sidhu, Satinderpal K. Satti, and Arshpreet S. Dhillon. "Subtrochanteric Femur Fracture in Neonates: A Rare Complication after Breech Presentation." Journal of Orthopedics and Joint Surgery 2, no. 2 (2020): 79–81. http://dx.doi.org/10.5005/jp-journals-10079-1028.

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ABSTRACT Fetus born in breech presentation are commonly delivered via cesarean section which is necessary to prevent trauma, and this extraction by operative maneuver can rarely lead to trauma and may result in femur fracture. But delivery of breech via vaginal route leads to various complications such as fractures. Femur fracture although being relatively a rare complication one of the most common fractures of the lower extremity presenting in newly born babies. In our case, 39-week mature fetus with weight 3,300 g breech presentation delivered by cesarean section presented with subtrochanteric femur fracture left side. A complete healing of the fracture, without any sequelae, was noted when the patient was simply immobilized with hip in flexion, abduction, and external rotation. The possibility of accidental injuries and traumatic complications are significantly reduced in cesarean section, especially in breech delivery when compared with vaginal delivery, but it does not completely eliminate the possible birth injuries and thus fractures of the newborn. So, clinicians must check for fractures even after cesarean section in breech presentation. How to cite this article: Singla S, Sharma R, Sharma R, et al. Subtrochanteric Femur Fracture in Neonates: A Rare Complication after Breech Presentation. J Orth Joint Surg 2020;2(2):79–81.
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Vidaeff, Alex C. "Breech Delivery Before and After the Term Breech Trial." Clinical Obstetrics and Gynecology 49, no. 1 (March 2006): 198–210. http://dx.doi.org/10.1097/01.grf.0000197545.64937.40.

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Djuric, Janko, Slobodan Arsenijevic, Dragic Bankovic, Zoran Protrka, Marija Sorak, Aleksandra Dimitrijevic, and Aleksandar Zivanovic. "Breech presentation at term: Caesarean section or vaginal delivery?" Srpski arhiv za celokupno lekarstvo 139, no. 3-4 (2011): 155–60. http://dx.doi.org/10.2298/sarh1104155d.

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Introduction. Term breech presentation occurs in 3-4% of all deliveries. Most obstetricians are completely sure how to end delivery when the foetus is in breech presentation, by caesarean section as the only option. Objective. The main goal of the paper was to present the method of delivery for term breech presentation analyzed at the Hospital of Gynaecology and Obstetrics and Clinical Centre in Kragujevac, and parameters that influenced the decision on the method of choice to perform delivery with the foetus in breech position. Methods. During a three-year prospective study, the course and outcome of all term breech deliveries were under follow-up. The study involved only deliveries in breech presentation, with a trial of labour ending by vaginal delivery, while elective caesarean section due to breech presentation of the foetus was not included in the study. The following parameters were compared: body mass, newborn?s first minute Apgar score and head circumference, gestational maturity, gestational age, delivery duration, maternal level of education and maternal parity. Results. Of total 6,470 deliveries, 653 (10.10%) were finalized by caesarean section. Of these, there were 202 (3.12%) term breech presentations, of which 72 (35.64%) women had caesarean and 130 (64.36%) vaginal delivery. A difference was detected in newborn?s body mass and head circumference, delivery duration, maternal level of education and parity between pregnancies terminated surgically in comparison to vaginal delivery, while pregnancy duration, maternal age, first minute Apgar score, and most significantly, perinatal morbidity did not show any difference regardless of the method of delivery for term breech presentation. Conclusion. With respect of all known parameters, vaginal delivery in breech presentation is also accepted.
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Fonseca, Andreia, Rita Silva, Inês Rato, Ana Raquel Neves, Carla Peixoto, Zita Ferraz, Inês Ramalho, et al. "Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?" Acta Médica Portuguesa 30, no. 6 (June 30, 2017): 479. http://dx.doi.org/10.20344/amp.7920.

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Introduction: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries.Material and Methods: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality.Results: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p < 0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p < 0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups.Discussion: Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar.Conclusion: Both delivery routes seem equally valid, neither posing high maternal or neonatal complications’ incidence.
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Kasela, J., Y. Ahmed, and B. Vwalika. "Feto-Maternal Outcomes of Term Assisted Breech Deliveries at the University Teaching Hospital, Lusaka, Zambia." Medical Journal of Zambia 45, no. 3 (November 21, 2018): 145–49. http://dx.doi.org/10.55320/mjz.45.3.146.

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Background: Breech presentation occurs when the fetus presents with buttocks or feet first. Globally, the incidence of breech is 3-4% at term. The safest mode of delivery for most breeches at term is still controversial despite extensive research. The aim of this study was to determine the feto-maternal outcomes of assisted term breech deliveries at the University Teaching Hospital (UTH). Methods: A cross sectional study was conducted in 73 pregnant women with term breech admitted to the labor ward that delivered vaginally. Data was collected by administering a structured questionnaire and from medical records. The Pearson's chi-squared test was used for comparison of proportions between groups. One multivariate logistic regression was used to determine associations with neonatal intensive care unit (NICU) admission and also a second one associations with type of breech. Results: The mean age of the participants was 30.6 ± 5.5 (range 18-41) years. The mean gestational age at delivery was 38.6 weeks and mean parity was 3.4, with a 5% history of previous breech. The average levels of asphyxia measured by Apgar score were 7.1 at 1 minute, 8.1 at 5 minutes and 8.6 at 10 minutes. The average fetal weight was 3200g, with 10% admissions to Neonatal intensive care unit(NICU). For the maternal outcomes, one participant had post- partum haemorrhage (PPH), and one participant had an episiotomy and none had symphysiotomy. On multivariate analysis, NICU admission was associated with lower Apgar score at 1 minute. Babies that were not admitted to NICU had 90% reduced odds for low Apgar score < 7 [Adjusted Odds Ratio (OR) = 0.10, 95% Confidence Interval (CI) = 0.004 – 0.24, P-value < 0.01. Also, on multivariate analysis, type of breech was associated with lower Agpar score at 5 minutes. Compared to footling breech, patients with extended breech had 97% reduced odds for low Apgar score < 7 (OR 0.03, 95% CI 0.004 – 0.22, p-value < 0.01). Patients with complete breech had 85% reduced odds for lower Apgar score < 7 (OR 0.15, 95% CI 0.05 – 0.44, p- value < 0.01). Discussion and Conclusion: Feto-maternal outcomes of assisted term vaginal breech deliveries at UTH were favourable with low levels of asphyxia, neonatal admissions to NICU, and need for blood transfusion. Therefore, breech vaginal delivery at term may still be a viable option at UTH as demonstrated by this study.
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Kasela, J., Y. Ahmed, and B. Vwalika. "Feto-maternal outcomes of term assisted breech deliveries at the University Teaching Hospital, Lusaka, Zambia." Medical Journal of Zambia 45, no. 3 (November 21, 2018): 145–49. http://dx.doi.org/10.55320/mjz.45.3.187.

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ackground: Breech presentation occurs when the fetus presents with buttocks or feet first. Globally, the incidence of breech is 3-4% at term. The safest mode of delivery for most breeches at term is still controversial despite extensive research. The aim of this study was to determine the feto-maternal outcomes of assisted term breech deliveries at the University Teaching Hospital (UTH). Methods: A cross sectional study was conducted in 73 pregnant women with term breech admitted to the labor ward that delivered vaginally. Data was collected by administering a structured questionnaire and from medical records. The Pearson's chi-squared test was used for comparison of proportions between groups. One multivariate logistic regression was used to determine associations with neonatal intensive care unit (NICU) admission and also a second one associations with type of breech. Results: The mean age of the participants was 30.6 ± 5.5 (range 18-41) years. The mean gestational age at delivery was 38.6 weeks and mean parity was 3.4, with a 5% history of previous breech. The average levels of asphyxia measured by Apgar score were 7.1 at 1 minute, 8.1 at 5 minutes and 8.6 at 10 minutes. The average fetal weight was 3200g, with 10% admissions to Neonatal intensive care unit (NICU). For the maternal outcomes, one participant had postpartum haemorrhage (PPH), and one participant had an episiotomy and none had symphysiotomy. On multivariate analysis, NICU admission was associated with lower Apgar score at 1 minute. Babies that were not admitted to NICU had 90% reduced odds for low Apgar score < 7 [Adjusted Odds Ratio (OR) = 0.10, 95% Confidence Interval (CI) = 0.004 – 0.24, P value < 0.01. Also, on multivariate analysis, type of breech was associated with lower Agpar score at 5 minutes. Compared to footling breech, patients with extended breech had 97% reduced odds for low Apgar score < 7 (OR 0.03, 95% CI 0.004 – 0.22, p-value < 0.01). Patients with complete breech had 85% reduced odds for lower Apgar score < 7 (OR 0.15, 95% CI 0.05 – 0.44, pvalue < 0.01). Discussion and Conclusion: Feto-maternal outcomes of assisted term vaginal breech deliveries at UTH were favourable with low levels of asphyxia, neonatal admissions to NICU, and need for blood transfusion. Therefore, breech vaginal delivery at term may still be a viable option at UTH as demonstrated by this study.
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Rydhstroem, Hakan. "Should all Twins be Delivered by Caesarean Section? A Preliminary Report." Twin Research 4, no. 3 (June 1, 2001): 156–58. http://dx.doi.org/10.1375/twin.4.3.156.

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AbstractThe aim was to analyse the neonatal mortality related to mode of delivery for twins using a population-based registry. In all, 18,125 twins delivered in Sweden between 1991 and 1997, after excluding those with unknown gestational duration, were used to analyse the differences between groups of twins. Results showed the OR for neonatal death, breech vaginal delivery versus caesarean section (all indications) was 1.47 (95% CI 0.99-2.17). The OR at vaginal delivery for neonatal death, twin I in breech versus cephalic presentation was 5.60 (2.62-11.94) and for twin II the corresponding figures were 1.85 (1.03-3.32). Analyses using population-based registries from other countries are needed to confirm or reject the present findings of an increased neonatal mortality for twins in breech presentation delivered vaginally.
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Sankaran, Suneela Mullakkal, and Jayasree Sukumara Sukumara Pillai. "Retrospective analysis of breech deliveries in tertiary care center." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 11 (October 27, 2020): 4549. http://dx.doi.org/10.18203/2320-1770.ijrcog20204808.

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Background: Breech presentation is the commonest malpresentation accounting for 3-4% of all deliveries at term. The most common cause for breech presentation is preterm delivery. The safest route of delivery for breech had long been a topic of debate and after the results of term breech trial mode of delivery has become abdominal route even in teaching institutions.Methods: This is a retrospective cross sectional study conducted at department of obstetrics and gynaecology, Government medical college, Kozhikode, for a period of 2 years from 01 January 2016 to 31 December 2017. Mothers with gestational age between 28 weeks to 41 weeks with singleton live fetus with breech presentation who had either vaginal or caesarean delivery were included. The case notes were retrieved from the medical records department.Results: A total of 823 breech deliveries occurred during the study period. Of the total mothers 429 were primies and 394 were multies. Common causes identified were prematurity, intrauterine growth restriction, uterine and fetal anomalies. Mode of delivery was caesarean in more than 80% of cases.Conclusions: Incidence of breech presentation was 3.2% during the study period. Increasing incidence of caesarean delivery is seen in breech presentation. Persistent breech presentation at term is most commonly seen in patients with associated oligamnios, intrauterine growth restriction, and uterine anomalies.
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Jennewein, Lukas, Dörthe Brüggmann, Kyra Fischer, Florian J. Raimann, Hemma Roswitha Pfeifenberger, Lena Agel, Nadja Zander, Christine Eichbaum, and Frank Louwen. "Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study." Journal of Clinical Medicine 10, no. 10 (May 14, 2021): 2117. http://dx.doi.org/10.3390/jcm10102117.

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Background: 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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Malla, Anagha Pradhan, Laxmi RC, Alka Singh, Reena Shrestha, Padma Gurung, Sushma Lama, Sarada Duwal Shrestha, and Binita Pradhan. "Outcome of breech delivery: caesarean section versus vaginal delivery at Patan Hospital, Patan Academy of Health Sciences." Journal of Patan Academy of Health Sciences 3, no. 1 (June 15, 2016): 4–9. http://dx.doi.org/10.3126/jpahs.v3i1.20282.

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Introductions: Obstetricians have long debated the role of caesarean section as a potentially safer mode of delivery for the fetus with breech presentation. However, the experience of the health care provider remains a critical element in the decision to pursue a vaginal breech delivery, and it may still be a viable option. The aim of this study is to determine the incidence of breech delivery at Patan Hospital and compare maternal and neonatal outcomes subjected to either vaginal or caesarean section.Methods: This was a five-year retrospective study of breech deliveries covering the year 2010 to 2014. Patient’s charts were retrieved from the medical record section and reviewed.Results: There were 896 breech deliveries out of a total 44,842 deliveries giving an incidence of 1.99%. One hundred thirteen (12.61%) of breech deliveries were through vaginal route while 431 (48.10%) and 352 (39.28%) were through emergency and elective caesarean sections respectively. There were 154 (17.18%) preterm breech deliveries including 27 (17.5%) preterm intrauterine death. Among term pregnancy, there were 3 neonatal deaths not associated with mode of delivery. None of the term infant had neurological morbidity comprising neonatal seizures, brachial plexus injury, chephalohematoma. Maternal blood loss was significantly higher in caesarean section group. Conclusions: In well-selected cases, the neonatal outcome following assisted vaginal breech delivery and caesarean section may not be different.Journal of Patan Academy of Health Sciences, Vol. 3, No. 1, 2016. page: 4-9
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Tiwary, Rimple, and Manish Kumar Tiwary. "Caesarean section with breech presentation and shaft femur fracture in newborn: a rare case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 1 (December 28, 2022): 246. http://dx.doi.org/10.18203/2320-1770.ijrcog20223503.

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Vaginal delivery for breech presentation is always associated with a higher risk of injury to the newborn as compared to caesarean delivery. A male infant was delivered by elective caesarean section at 40 weeks of gestation for breech presentation. During extraction, the newborn sustained a right femur shaft fracture. A simple splint with immobilization along with leg raise led to complete healing without complication. Caesarean delivery is associated with a reduced risk of newborn birth injuries as compared to vaginal and instrumental delivery but rare accidental complication can be possible.
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34

Pulido Valente, Maria, Maria Carvalho Afonso, and Nuno Clode. "Is Vaginal Breech Delivery Still a Safe Option?" Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 42, no. 11 (November 2020): 712–16. http://dx.doi.org/10.1055/s-0040-1713804.

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Abstract Objective To determine whether there was any difference in neonatal and maternal outcomes between breech vaginal delivery and cephalic vaginal delivery. Methods A retrospective, case-control study was conducted between January 2015 and December 2017 in a Portuguese hospital. A total of 26 cases of breech vaginal delivery were considered eligible and 52 pregnant women formed the control group. Results Induced labor was more frequent in the breech vaginal delivery group (46% versus 21%, p = 0.022). Episiotomy was more common in the breech vaginal delivery group (80% versus 52%, p = 0.014), and one woman had a 3rd degree perineal laceration. Newborns in the study group had a lower birthweight (2,805 g versus 3,177 g, p < 0.001). There was no significant difference in the neonatal outcomes. Conclusion The present study showed that breech vaginal delivery at term compared with cephalic presentation was not associated with significant differences in neonatal and maternal morbidity. It also suggests that breech vaginal delivery remains a safe option under strict selection criteria and in the presence of an experienced obstetrician.
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35

Ron, M., D. Scherer, D. Hochner-Celnikier, and Z. Palti. "Fetal tachycardia during breech delivery." Journal of Obstetrics and Gynaecology 6, no. 2 (January 1985): 96–97. http://dx.doi.org/10.3109/01443618509079154.

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36

øian, Pål, Inge Skråmm, Einar Hannisdal, and Knut Bjøro. "Breech Delivery An obstetrical analysis." Acta Obstetricia et Gynecologica Scandinavica 67, no. 1 (January 1988): 75–79. http://dx.doi.org/10.3109/00016348809004172.

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Hehir, Mark P. "Trends in vaginal breech delivery." Journal of Epidemiology and Community Health 69, no. 12 (July 15, 2015): 1237–39. http://dx.doi.org/10.1136/jech-2015-205592.

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38

Hardy, Janet R. "Intergenerational recurrence of breech delivery." BMJ 336, no. 7649 (March 27, 2008): 843–44. http://dx.doi.org/10.1136/bmj.39527.608542.80.

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CHADHA, YOGESH C., TAHIR A. MAHMOOD, MICHAEL J. DICK, NORMAN C. SMITH, DORIS M. CAMPBELL, and ALLAN TEMPLETON. "Breech Delivery and Epidural Analgesia." Obstetrical & Gynecological Survey 47, no. 9 (September 1992): 618–19. http://dx.doi.org/10.1097/00006254-199209000-00009.

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CHADHA, Y. C., T. A. MAHMOOD, M. J. DICK, N. C. SMITH, D. M. CAMPBELL, and A. TEMPLETON. "Breech Delivery and Epidural Anesthesia." Survey of Anesthesiology 36, no. 6 (December 1992): 355. http://dx.doi.org/10.1097/00132586-199212000-00018.

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Kotaska, Andrew, Savas Menticoglou, Robert Gagnon, Robert Gagnon, Dan Farine, Melanie Basso, Hayley Bos, et al. "Vaginal Delivery of Breech Presentation." Journal of Obstetrics and Gynaecology Canada 31, no. 6 (June 2009): 557–66. http://dx.doi.org/10.1016/s1701-2163(16)34221-9.

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42

Nkata, Mulumba. "Perinatal Mortality in Breech Delivery." Tropical Doctor 31, no. 4 (October 2001): 222–23. http://dx.doi.org/10.1177/004947550103100418.

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BLICKSTEIN, ISAAC, RAN D. GOLDMAN, and MICHAEL KUPFERMINC. "Delivery of Breech First Twins." Obstetrics & Gynecology 95, no. 1 (January 2000): 37–42. http://dx.doi.org/10.1097/00006250-200001000-00008.

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Shah, P. N., and A. S. Moolgaoker. "Breech delivery and epidural analgesi." BJOG: An International Journal of Obstetrics and Gynaecology 99, no. 9 (September 1992): 781. http://dx.doi.org/10.1111/j.1471-0528.1992.tb13890.x.

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Smedstad, Kabri G., and D. H. Morison. "Breech delivery and epidural analgesia." BJOG: An International Journal of Obstetrics and Gynaecology 99, no. 9 (September 1992): 782–83. http://dx.doi.org/10.1111/j.1471-0528.1992.tb13891.x.

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CHADHA, YOGESH C., TAHIR A. MAHMOOD, MICHAEL J. DICK, NORMAN C. SMITH, DORIS M. CAMPBELL, and ALLAN TEMPLETON. "Breech delivery and epidural analgesia." BJOG: An International Journal of Obstetrics and Gynaecology 99, no. 2 (February 1992): 96–100. http://dx.doi.org/10.1111/j.1471-0528.1992.tb14462.x.

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Seffah, J. D., and J. O. Armah. "Antenatal ultrasonography for breech delivery." International Journal of Gynecology & Obstetrics 68, no. 1 (December 20, 1999): 7–12. http://dx.doi.org/10.1016/s0020-7292(99)00164-2.

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Kotaska, Andrew, Savas Menticoglou, Robert Gagnon, Dan Farine, Melanie Basso, Hayley Bos, Marie-France Delisle, et al. "Vaginal delivery of breech presentation." International Journal of Gynecology & Obstetrics 107, no. 2 (August 8, 2009): 169–76. http://dx.doi.org/10.1016/j.ijgo.2009.07.002.

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Myers, Stephen A., and Norbert Gleicher. "Breech delivery: Why the dilemma?" American Journal of Obstetrics and Gynecology 156, no. 1 (January 1987): 6–10. http://dx.doi.org/10.1016/0002-9378(87)90193-1.

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Cohen, Ronnie, Lior Kashani Ligumsky, Miriam Lopian, avshalom elmalech, Ioana Olteanu, Joseph B. Lessing, michael cohen, Mirra Manevich Mazor, and gabi haran. "Delivery of second breech twin.Comparison between vaginal delivery of vertex and breech second twins." American Journal of Obstetrics and Gynecology 226, no. 1 (January 2022): S129—S130. http://dx.doi.org/10.1016/j.ajog.2021.11.229.

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