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Journal articles on the topic 'Breech presentation'

Author: Grafiati
Published: 4 June 2021
Last updated: 28 July 2024

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1

IRSHAD RAO, SHAHID, SHAZIA SIDDIQ, and RABIA REHMAN. "BREECH PRESENTATION." Professional Medical Journal 19, no. 04 (August 7, 2012): 542–45. http://dx.doi.org/10.29309/tpmj/2012.19.04.2278.

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Objective: To determine the frequency of breech presentation at term. Design: Cross sectional study. Setting: Department ofObstetrics and Gynaecoogy, Unit-III, Nishtar Hospital, Multan. Period: June 2010 to May 2011 Material and methods: This study was carriedout in women with the age group 0-40 years. Breech presentation at term (37-41 completed weeks). Results: The frequency of breechpresentation at term was found to be 6.2%. 91% (215) of the patients were delivered by caesarean section and 9% (20) were delivered vaginally.Placenta previa and multiple pregnancy 8.51% each, congenital anomalies 4.25% and in 16.17% of the patients, no obvious cause was found.Conclusion: It is concluded from the study that the frequency of the breech presentation at term increased.
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2

Cruikshank, Dwight P. "Breech Presentation." Clinical Obstetrics and Gynecology 29, no. 2 (June 1986): 255–63. http://dx.doi.org/10.1097/00003081-198606000-00008.

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3

Eller, Daniel P., and J. Peter VanDorsten. "Breech presentation." Current Opinion in Obstetrics and Gynecology 5, no. 5 (October 1993): 664–68. http://dx.doi.org/10.1097/00001703-199310000-00014.

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4

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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5

Umoh AV, Abah MG, and Umoiyoho AJ. "Breech presentation – An overview." Ibom Medical Journal 2, no. 1 (February 1, 2007): 31–36. http://dx.doi.org/10.61386/imj.v2i1.17.

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IntroductionBreech presentation is a form of mal-presentation in which the fetal buttocks or lower extremities occupy or is in direct relationship with the maternal pelvic inlet. It is the commonest form of mal-presentation of the fetus. Its incidence decreases with advancing age from 25% at 28 Weeks, through 15% at 32 Weeks to 2-4% at term[1-3]. It accounts for 3-4% of infants born at term or at least 20,000 babies per year in the United Kingdom[3-5]. It is commoner in preterm babies and may be associated with both fetal and maternal anomalies. There has been intense debate about the safest mode of delivery for breech babies[5,6].Depending on the attitude of the fetus, breech presentation has been classified as:(a) Frank or Extended breech presentation when the fetal hips are flexed and the knees extended. It is also called 'pike'. This accounts for 50-70% of breech presentations and is commoner in Primigravidae;(b) Complete or Flexed breech presentation when both the hips and the knees are flexed. It is also described as 'cannon ball' and accounts for 5-10% of breech presentations. It is commoner in Multiparous women.(c) Footling or Incomplete breech presentation when one or both hips are extended. Here the foot (or feet) lies below the fetal buttock and either it or the knee(s) may be presenting[3,5,7].
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6

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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7

Bergenhenegouwen, Lester, Floortje Vlemmix, Sabine Ensing, Jelle Schaaf, Joris van der Post, Ameen Abu-Hanna, Anita C. J. Ravelli, Ben W. Mol, and Marjolein Kok. "Preterm Breech Presentation." Obstetrics & Gynecology 126, no. 6 (December 2015): 1223–30. http://dx.doi.org/10.1097/aog.0000000000001131.

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8

Sentilhes, Loïc, Stéphanie Brun, Elsa Lorthe, and Gilles Kayem. "Preterm Breech Presentation." Obstetrics & Gynecology 127, no. 6 (June 2016): 1170. http://dx.doi.org/10.1097/aog.0000000000001458.

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9

Schafer, Robyn, Marit L. Bovbjerg, Melissa Cheyney, and Julia C. Phillippi. "Maternal and neonatal outcomes associated with breech presentation in planned community (home and birth center) births in the United States: A prospective observational cohort study." PLOS ONE 19, no. 7 (July 22, 2024): e0305587. http://dx.doi.org/10.1371/journal.pone.0305587.

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Objective Investigate maternal and neonatal outcomes associated with breech presentation in planned community births in the United States, including outcomes associated with types of breech presentation (i.e., frank, complete, footling/kneeling) Design Secondary analysis of prospective cohort data from a national perinatal data registry (MANA Stats) Setting Planned community birth (homes and birth centers), United States Sample Individuals with a term, singleton gestation (N = 71,943) planning community birth at labor onset Methods Descriptive statistics to calculate associations between types of breech presentation and maternal and neonatal outcomes Main outcome measures Maternal: intrapartum/postpartum transfer, hospitalization, cesarean, hemorrhage, severe perineal laceration, duration of labor stages and membrane rupture Neonatal: transfer, hospitalization, NICU admission, congenital anomalies, umbilical cord prolapse, birth injury, intrapartum/neonatal death Results One percent (n = 695) of individuals experienced breech birth (n = 401, 57.6% vaginally). Most fetuses presented frank breech (57%), with 19% complete, 18% footling/kneeling, and 5% unknown type of breech presentation. Among all breech labors, there were high rates of intrapartum transfer and cesarean birth compared to cephalic presentation (OR 9.0, 95% CI 7.7–10.4 and OR 18.6, 95% CI 15.9–21.7, respectively), with no substantive difference based on parity, planned site of birth, or level of care integration into the health system. For all types of breech presentations, there was increased risk for nearly all assessed neonatal outcomes including hospital transfer, NICU admission, birth injury, and umbilical cord prolapse. Breech presentation was also associated with increased risk of intrapartum/neonatal death (OR 8.5, 95% CI 4.4–16.3), even after congenital anomalies were excluded. Conclusions All types of breech presentations in community birth settings are associated with increased risk of adverse neonatal outcomes. These research findings contribute to informed decision-making and reinforce the need for breech training and research and an increase in accessible, high-quality care for planned vaginal breech birth in US hospitals.
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10

Benmessaoud, Ines, Margot Jamey, Barbara Monard, Jean-Patrick Metz, Aude Bourtembourg-Matras, Rajeev Ramanah, Didier Riethmuller, Abdellah Hedjoudje, and Nicolas Mottet. "Analysis of spontaneous labor progression of breech presentation at term." PLOS ONE 17, no. 3 (March 14, 2022): e0262002. http://dx.doi.org/10.1371/journal.pone.0262002.

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Background Cervical dilatation curves are widely used to describe normal and abnormal labor progression for cephalic presentation. Labor curves for breech presentations have never been described. Objectives The aims of this study were to examine the pattern of labor progression in women with a breech presentation and to determine whether the type of breech or parity can influence the speed of cervical dilatation. Study design We analyzed the labor data from 349 women with a term, singleton, and breech fetus after spontaneous onset of labor in 2010–2018. Cesarean deliveries were excluded. The patterns of labor progression were described by examining the relationship between the elapsed times from the full dilatation and cervical dilatation stages. Average labor curves were developed using repeated-measures analysis with 3rd degree polynomial modeling. The results were interpreted according to parity and the type of breech. Results The first stage of labor progression was divided into a latency phase from 0 to 5 cm of dilatation and an active phase from 5 to 10 cm. In the active phase, the median speed of cervical dilatation was 1.67 cm/h [1.25, 2.61] (2 cm/h for multipara and 1.54 cm/h for nullipara). The difference by parity was significant in the active phase (p< 0.05). The cervical dilatation rate from 3 cm to 10 cm did not significantly differ between the complete and frank breeches (1.56 cm/h vs 1.75 cm/h, p = 0.48). However, the median cervical dilatation rate from 8 cm to complete dilatation was faster for complete breeches (1.92 cm/h versus 1.33 cm/h, p = 0.045). Conclusion As with cephalic presentation, the first stage of labor progression for breech presentation can be divided into a latent and active phase. Labor progression should be interpreted with respect to parity, and women should be informed that the type of breech does not seem to influence the cervical dilatation rate when there is adequate management.
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11

Zubor, Pavol, Imrich Zigo, Jana Sivakova, Petra Moricova, Ivana Kapustova, Stefan Krivus, and Jan Danko. "Repetitive Breech Presentations at Term." Case Reports in Obstetrics and Gynecology 2013 (2013): 1–4. http://dx.doi.org/10.1155/2013/628572.

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The authors present a case of 38-year-old laboring woman with four-time repetitive breech presentation of the fetus at term. This rare condition affects the mode of delivery and represents serious obstetrical problem as it is associated with increased perinatal morbidity or mortality. The authors give details on risk factors for breech presentation, its diagnosis, and the discussion points on possible causes leading to repetitive breeches in laboring women.
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12

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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Slavov, Sergei Svetoslavov. "Malpresentation of the Fetus in Singleton Pregnancies after In Vitro Fertilization." Open Access Macedonian Journal of Medical Sciences 9, B (July 29, 2021): 573–76. http://dx.doi.org/10.3889/oamjms.2021.6450.

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BACKGROUND: There are some data in the literature that show an increased incidence of breech presentation and other non-cephalic presentations in vitro fertilization (IVF) singleton pregnancies compared to spontaneous ones. AIM: The purpose of our study was to compare IVF and spontaneous singleton pregnancies in terms of frequency of breech presentation and its impact on the mode of delivery. Furthermore, we wanted to study the rate of transverse and oblique lie in both groups. MATERIALS AND METHODS: We conducted a prospective and retrospective study at “Maichin Dom” University Hospital in Sofia, Bulgaria for the period from January 2013 to December 2017 and analyzed 402 singleton IVF pregnancies and compared them with 523 spontaneous singleton pregnancies. The primary outcome was a breech presentation of the fetus. RESULTS: We found a significantly higher rate of breech presentation in IVF compared to spontaneous pregnancies (p < 0.001). According to gestational age, the difference between the groups persisted when the pregnancy was at least the 32nd week of gestation. We found no difference in the frequency of vaginal birth in the two groups when the fetus was in breech presentation CONCLUSION: IVF singleton pregnancies are associated with a higher risk of breech presentation. Further research is needed to determine the factors contributing to the higher incidence of breech presentation among patients undergoing IVF.
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MUKHTAR,, BUSHRA, BUSHRA KHAN, and NUZHAT RASHEED. "BREECH PRESENTATION AT TERM;." Professional Medical Journal 20, no. 04 (August 15, 2013): 526–29. http://dx.doi.org/10.29309/tpmj/2013.20.04.1027.

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Objective: To compare the fetal outcome of elective cesarean section with elective vaginal birth for Term Breechpresentation in terms of APGAR Score, Respiratory Distress Syndrome, Admission in Neonatology Unit and Neonatal mortality. Design:Quasi experimental study. Setting: Department of Obstetrics & Gynaecololgy Bahawal Victoria Hospital, Bahawalpur. Methods: Total 120cases were included in the study divided into two groups, each having 60 fulfilling the inclusion criteria. Group 'A' had those who deliveredby planned cesarean and Group 'B' comprised those having planned vaginal delivery. Results: It was found that neonatal mortality was3.33 in vaginal and 0 in cesarean group. Mean APGAR Score at 1 and 5 minute was 8.47 and 9.53 in vaginal and 8.58 and 9.62 incesarean group. RDS was more in cesarean (5) than vaginal group (1.6). Admission in Neonatalogy Unit was more in vaginally deliveredgroup (8.33) as compared to the cesarean section group (5). Conclusion: Planned cesarean delivery in breech presentation at term isassociated with a reduction in neonatal mortality and morbidity as compared to the planned vaginal birth.
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Budd, Sarah. "Moxibustion for breech presentation." Complementary Therapies in Nursing and Midwifery 6, no. 4 (November 2000): 176–79. http://dx.doi.org/10.1054/ctnm.2000.0505.

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16

Meyer-Koenig, P. "Pulsatilla for breech presentation." British Homoeopathic journal 84, no. 2 (April 1995): 111. http://dx.doi.org/10.1016/s0007-0785(95)80051-4.

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Rane, Sunit M., and Vicky M. Osgood. "MANAGEMENT OF BREECH PRESENTATION." Obstetrician & Gynaecologist 2, no. 4 (October 2000): 53. http://dx.doi.org/10.1576/toag.2000.2.4.53.

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18

Gaikwad H, Bhupesh, and Rahul Maskar P. "ANALYSIS OF BREECH PRESENTATION." Journal of Evolution of Medical and Dental Sciences 5, no. 05 (January 16, 2016): 280–82. http://dx.doi.org/10.14260/jemds/2016/60.

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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

Patel, N. "Management of breech presentation." European Journal of Obstetrics & Gynecology and Reproductive Biology 24, no. 2 (February 1987): 98–99. http://dx.doi.org/10.1016/0028-2243(87)90175-4.

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21

Wong, H. C. G. "Moxibustion for Breech Presentation." JAMA: The Journal of the American Medical Association 282, no. 14 (October 13, 1999): 1329–30. http://dx.doi.org/10.1001/jama.282.14.1329.

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22

Buekens, P., R. Lagasse, F. Puissant, and F. Leroy. "Do Breech Presentations in Twins and Singletons Run Different Risks?" Acta geneticae medicae et gemellologiae: twin research 34, no. 3-4 (October 1985): 207–11. http://dx.doi.org/10.1017/s000156600000475x.

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AbstractWe have compared breech twins and breech single births in a population recorded between 1974 and 1978 in 10 Belgian maternity centers. In 190 twin pregnancies, 38 first and 65 second twins were delivered in breech presentation. These twins were compared to 853 singleton breeches, of which 95 delivered by cesarean section were excluded. Data were stratified according to birthweight. No significant difference between twins and singletons was found in terms of perinatal mortality rates. However, Apgar scores below 7 at 5 minutes were significantly less numerous among first twins than among singletons. Therefore, first twins in breech presentation might be at lower risk of fetal distress. This difference should be taken into account in the management of first twins presenting by the breech.
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23

Noli, Stefania Antonia, Ilaria Baini, Fabio Parazzini, Paola Agnese Mauri, Michele Vignali, Sandro Gerli, Alessandro Favilli, and Sonia Cipriani. "Preterm Birth, Low Gestational Age, Low Birth Weight, Parity, and Other Determinants of Breech Presentation: Results from a Large Retrospective Population-Based Study." BioMed Research International 2019 (September 16, 2019): 1–6. http://dx.doi.org/10.1155/2019/9581439.

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Aim of this study is to analyze determinants of breech presentation using information from two regional databases of Lombardy (Italy) including data on consecutive singleton breech and vertex deliveries occurred in the Region, between January 2010 and December 2015. Breech presentation occurred in 3.8% of all single deliveries. Main determinants of breech presentation at birth were: gestational age and birth weight (the lower, the higher the incidence of breech presentation), maternal age (the older the mother, the higher the risk of breech presentation), parity (the frequency of breech decreased with increasing parity) and previous cesarean section. Breech presentation resulted more frequent after assisted reproduction procedures.
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N., Deepika, and Arun Kumar. "External cephalic version at 36 weeks and its outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 10 (September 23, 2017): 4602. http://dx.doi.org/10.18203/2320-1770.ijrcog20174449.

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Background: External cephalic version (ECV) is well known non-invasive procedure done for the management of breech presentation but is not routinely practised by obstetricians in many clinical settings. The aim of the study was to assess the success rate of external cephalic version, labour outcome of pregnancy after successful ECV, to study maternal and foetal complications associated with ECV and to explore the reasons for failed ECV.Methods: It was a prospective interventional study to assess the labour outcomes of pregnancies with successful and uncomplicated ECV. All women who had singleton breech presentation at 36+ weeks were included unless contraindications for ECV were present. After obtaining consent, ECV was attempted after giving tocolysis.Results: The total number of deliveries was 6038 in the same period. Out of these 301 were breech presentations thus the incidence of breech presentation was 4.9%. ECV was offered to 81 women (26.9%) and out of these 77 women (95.06%) gave consent for the procedure. The remaining 4 (4.93%) did not give consent due to anxiety about the procedure. The success rate was 54.54%. Out of total 301 women with breech presentation 40 women (13.3%) had assisted breech delivery and 216 women (71.8%) had caesarean section due to obstetric indications. Thus the caesarean section rate for breech presentation at our institute was 71.8%. ECV was successful in 63.82% of the multigravida on which it was attempted as compared to 40% of the primigravida. The success rate of ECV in the present study is maximum when ECV was performed at a gestational age of 38-39 weeks and when fetal weight was less than 3000 grams. Out of the 42 successful ECV cases, 4 babies (9.52%) had neonatal sepsis and 1 was still born (2.3%) which was unrelated to ECV.Conclusions: ECV is a valuable though under used option in the management of breech presentation at term. It is a relatively safe procedure, simple to learn and perform. Vigilance for breech presentation after 36 weeks is important. ECV at term using tocolytics should be part of the routine management of breech presentation.
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Londero, Ambrogio, Claudia Massarotti, Anjeza Xholli, Arrigo Fruscalzo, and Angelo Cagnacci. "Assisted Reproductive Technology and Breech Delivery: A Nationwide Cohort Study in Singleton Pregnancies." Journal of Personalized Medicine 13, no. 7 (July 16, 2023): 1144. http://dx.doi.org/10.3390/jpm13071144.

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Since essential factors have changed in recent years in assisted reproduction technologies (ARTs), this study reassessed the association between ART and breech presentation. We primarily aimed to estimate the correlation between ART and breech at delivery. Secondary purposes were to evaluate the correlation between other subfertility treatments (OSTs) and breech and to assess possible confounding factors and temporal trends. This study investigated the 31,692,729 live birth certificates from US states and territories in the 2009–2020 period. The inclusion criteria were singleton births reporting the method of conception and the presentation at delivery. The outcome was the breech presentation at delivery, while the primary exposure was ART, the secondary exposure was OST, and the potential confounding factors from the literature were considered. ART (OR 2.32 CI.95 2.23–2.41) and OST (OR 1.79 CI.95 1.71–1.87) were independent and significant risk factors for breech at delivery (p < 0.001). This study confirmed breech presentation risk factors maternal age, nulliparity, tobacco smoke, a previous cesarean delivery (CD), neonatal female sex, gestational age, and birth weight. Black race and Hispanic origin were verified to be protective factors. We found breech prevalence among ART and OST to be stable during the study period. Meanwhile, newborn birth weight was increased, and the gap between breech and other presentations in ART was reduced. Our results indicate that singleton pregnancies conceived by ART or OST were associated with a higher risk of breech at delivery. Well-known risk factors for the breech presentation were also confirmed. Some of these factors can be modified by implementing interventions to reduce their prevalence (e.g., tobacco smoke and previous CD).
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Knights, Samantha, Smriti Prasad, Erkan Kalafat, Anahita Dadali, Pam Sizer, Francoise Harlow, and Asma Khalil. "Impact of point-of-care ultrasound and routine third trimester ultrasound on undiagnosed breech presentation and perinatal outcomes: An observational multicentre cohort study." PLOS Medicine 20, no. 4 (April 6, 2023): e1004192. http://dx.doi.org/10.1371/journal.pmed.1004192.

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Background Accurate knowledge of fetal presentation at term is vital for optimal antenatal and intrapartum care. The primary objective was to compare the impact of routine third trimester ultrasound or point-of-care ultrasound (POCUS) with standard antenatal care, on the incidence of overall and proportion of all term breech presentations that were undiagnosed at term, and on the related adverse perinatal outcomes. Methods and findings This was a retrospective multicentre cohort study where we included data from St. George’s (SGH) and Norfolk and Norwich University Hospitals (NNUH). Pregnancies were grouped according to whether they received routine third trimester scan (SGH) or POCUS (NNUH). Women with multiple pregnancy, preterm birth prior to 37 weeks, congenital abnormality, and those undergoing planned cesarean section for breech presentation were excluded. Undiagnosed breech presentation was defined as follows: (a) women presenting in labour or with ruptured membranes at term subsequently discovered to have a breech presentation; and (b) women attending for induction of labour at term found to have a breech presentation before induction. The primary outcome was the proportion of all term breech presentations that were undiagnosed. The secondary outcomes included mode of birth, gestational age at birth, birth weight, incidence of emergency cesarean section, and the following neonatal adverse outcomes: Apgar score <7 at 5 minutes, unexpected neonatal unit (NNU) admission, hypoxic ischemic encephalopathy (HIE), and perinatal mortality (including stillbirths and early neonatal deaths). We employed a Bayesian approach using informative priors from a previous similar study; updating their estimates (prior) with our own data (likelihood). The association of undiagnosed breech presentation at birth with adverse perinatal outcomes was analyzed with Bayesian log-binomial regression models. All analyses were conducted using R for Statistical Software (v.4.2.0). Before and after the implementation of routine third trimester scan or POCUS, there were 16,777 and 7,351 births in SGH and 5,119 and 4,575 in NNUH, respectively. The rate of breech presentation in labour was consistent across all groups (3% to 4%). In the SGH cohort, the percentage of all term breech presentations that were undiagnosed was 14.2% (82/578) before (years 2016 to 2020) and 2.8% (7/251) after (year 2020 to 2021) the implementation of universal screening (p < 0.001). Similarly, in the NNUH cohort, the percentage of all term breech presentations that were undiagnosed was 16.2% (27/167) before (year 2015) and 3.5% (5/142) after (year 2020 to 2021) the implementation of universal POCUS screening (p < 0.001). Bayesian regression analysis with informative priors showed that the rate of undiagnosed breech was 71% lower after the implementation of universal ultrasound (RR, 0.29; 95% CrI 0.20, 0.38) with a posterior probability greater than 99.9%. Among the pregnancies with breech presentation, there was also a very high probability (>99.9%) of reduced rate of low Apgar score (<7) at 5 minutes by 77% (RR, 0.23; 95% CrI 0.14, 0.38). There was moderate to high probability (posterior probability: 89.5% and 85.1%, respectively) of a reduction of HIE (RR, 0.32; 95% CrI 0.0.05, 1.77) and extended perinatal mortality rates (RR, 0.21; 95% CrI 0.01, 3.00). Using informative priors, the proportion of all term breech presentations that were undiagnosed was 69% lower after the initiation of universal POCUS (RR, 0.31; 95% CrI 0.21, 0.45) with a posterior probability greater of 99.9%. There was also a very high probability (99.5%) of a reduced rate of low Apgar score (<7) at 5 minutes by 40% (RR, 0.60; 95% CrI 0.39, 0.88). We do not have reliable data on number of facility-based ultrasound scans via the standard antenatal referral pathway or external cephalic versions (ECVs) performed during the study period. Conclusions In our study, we observed that both a policy of routine facility-based third trimester ultrasound or POCUS are associated with a reduction in the proportion of term breech presentations that were undiagnosed, with an improvement in neonatal outcomes. The findings from our study support the policy of third trimester ultrasound scan for fetal presentation. Future studies should focus on exploring the cost-effectiveness of POCUS for fetal presentation.
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Tsakiridis, Ioannis, Apostolos Mamopoulos, Apostolos Athanasiadis, and Themistoklis Dagklis. "Management of Breech Presentation: A Comparison of Four National Evidence-Based Guidelines." American Journal of Perinatology 37, no. 11 (June 5, 2019): 1102–9. http://dx.doi.org/10.1055/s-0039-1692391.

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Abstract Objective The management of breech presentation may improve perinatal outcomes. The aim of this study was to synthesize and compare published evidence of four national guidelines on breech presentation. Study Design A descriptive review of four recently published national guidelines on breech presentation and external cephalic version (ECV) was conducted: Royal College of Obstetricians and Gynaecologists guideline on “External Cephalic Version and Reducing the Incidence of Term Breech Presentation” and “Management of Breech Presentation”, American College of Obstetricians and Gynecologists guideline on “External Cephalic Version” and “Mode of Term Singleton Breech Delivery,” Society of Obstetricians and Gynaecologists of Canada guideline on “Vaginal Delivery of Breech Presentation” and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists guideline on “Management of breech presentation at term.” Results Regarding ECV, there is no recommendation by the SOGC, whereas all other national guidelines recommend this technique. Regarding breech vaginal delivery, there are limited recommendations by the ACOG, whereas all other guidelines provide similar recommendations. The RANZCOG makes no special recommendations on the intrapartum period. Conclusion The differences among national guidelines point out the need for the adoption of an international consensus on the management of breech presentation.
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Mehta, Siddharth, Neeta Natu, and Shefali Jain. "Maternal and perinatal outcome in term singleton breech presentation at term pregnancy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 4 (March 28, 2023): 959–63. http://dx.doi.org/10.18203/2320-1770.ijrcog20230794.

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Background: Breech presentation is defined as a fetus in a longitudinal lie with the podalic at the pelvic brim. There are three types of breech presentations: frank breech, complete, incomplete breech. The incidence of breech presentation decreases from about 20% at 28 weeks of gestation to 3-4% at term, as most babies turn spontaneously to the cephalic presentation. Studies have shown that the prevalence of term breech presentation varies globally. In India the incidence was shown to be, 2.1%, and in other Asian countries it was found to be around 2.9 -4.5%. Its incidence is around 25% at 28 weeks of gestation and it reduces to 4% by term. If patients are carefully selected, breech presentation can be delivered vaginally. However, the risk of neonatal complications still persists. sometimes the planned vaginal delivery has to be converted into emergency cesarean section. Such probability varies from 17.4 to 51%. Methods: This was a prospective observational study conducted in department of obstetrics and gynaecology department of SAMC and PGI, Indore, Madhya Pradesh from 1st April, 2021 to 31st October 2022. Ethical approval was taken from the institutional review committee. All term pregnant women (≥37 weeks) aged 18 years and above, admitted to the maternity and labor ward with the diagnosis of singleton breech presentation during the study period were included in the study. The patients were identified as having breech presentation on admission using physical examination and ultrasound. Those women who presented with antepartum hemorrhage, uterine rupture, fetuses with major congenital anomalies and intrauterine deaths were excluded from the study. After through exclusion sample of 70 people were included in study. Results: During the study period, 896 deliveries were conducted in this hospital. Among them, 70 (7.86%) of the deliveries were singleton breech delivery. The age of the participants in the study ranged from 16 to 45 years, with a mean age of 27.07±8.56 years. Most of them had elective cesarean section, and few had emergency cesarean section. The most common indication for emergency cesarean section was footling presentation. Most of the new-borns were males, mean weight of new-borns 2.75±0.5 kg. 21.9% neonates required admission in neonatal intensive care unit, 2.8% mothers developed wound infection and 10% had post-partum haemorrhage. Conclusions: Proper guidance, education and strict adherent to principles and steps of breech delivery, like monitoring taking up call for emergency c-sections, having proper NICU setup, trained doctors will help in reduction of complications. A protocol for the management of breech delivery and a regular training facility for junior health professionals to conduct assisted vaginal breech delivery are highly recommended.
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Kanajura, Yoichi, Kunio Kometani, Tetsurou Nagata, Kuniaki Niwa, Hiroshi Kamatsuki, Yasutaka Shinzato, and Yasumoto Tokunaga. "Moxibustion Treatment of Breech Presentation." American Journal of Chinese Medicine 29, no. 01 (January 2001): 37–45. http://dx.doi.org/10.1142/s0192415x01000058.

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Breech presentation was successfully corrected by stimulating acupuncture points with moxibustion or low-frequency electrical current. Only patients with breech pregnancies at the 28th week or later were entered into the study. With moxibustion treatment, the control group had a spontaneous correction rate of 165/224 (73.66%), and the treatment group had a correction rate of 123/133 (92.48%) (P < 0.0001, x2 test). With low-frequency percutaneous electrical stimulation, the correction rate was 20/941 (83.87%) in the control group and 171/191 (89.52%) in the treatment group (P = 0.094, x2 test). The control is the moxibustion study did no exercises and received no external manipulation to correct breech presentation whereas those in the electrical stimulation study experienced both. Acupuncture stimulation, especially with moxibustion, is expected to serve as a safe and effective modality in the management of breech presentation in a clinical setting.
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Singh, Raman. "EXAMINING PREGNANCY OUTCOMES AFTER EXTERNAL CEPHALIC VERSION FOR BREECH PRESENTATION." Global Journal of Medical and Pharmaceutical Sciences 02, no. 11 (November 7, 2023): 01–08. http://dx.doi.org/10.55640/gjmps-abcd112.

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External cephalic version (ECV) is a non-invasive procedure performed to reposition a breech fetus into the cephalic position before labor, thus reducing the risk of cesarean delivery. This study aims to examine pregnancy outcomes following external cephalic version for breech presentation. A retrospective analysis of maternal and neonatal outcomes was conducted among women who underwent ECV for breech presentation at a tertiary care center over a specified period. Data on the success rate of ECV, mode of delivery, neonatal outcomes, and maternal complications were collected and analyzed. The findings provide insights into the safety and effectiveness of ECV in improving pregnancy outcomes for women with breech-presenting fetuses.
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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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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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Scorza, William E. "Intrapartum Management of Breech Presentation." Clinics in Perinatology 23, no. 1 (March 1996): 31–49. http://dx.doi.org/10.1016/s0095-5108(18)30252-5.

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ALBRECHTSEN, SUSANNE, SVEIN RASMUSSEN, KNUT DALAKER, and LORENTZ M. IRGENS. "Reproductive Career After Breech Presentation." Obstetrics & Gynecology 92, no. 3 (September 1998): 345–50. http://dx.doi.org/10.1097/00006250-199809000-00005.

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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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Tiran, Denise. "Breech presentation: increasing maternal choice." Complementary Therapies in Nursing and Midwifery 10, no. 4 (November 2004): 233–38. http://dx.doi.org/10.1016/j.ctnm.2004.01.005.

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Flanagan, Tracy A., Kristi M. Mulchahey, Carol C. Korenbrot, James R. Green, and Russell K. Laros. "Management of term breech presentation." American Journal of Obstetrics and Gynecology 156, no. 6 (June 1987): 1492–502. http://dx.doi.org/10.1016/0002-9378(87)90022-6.

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FLANAGAN, TRACY A., KRISTI M. MULCHAHEY, CAROL C. KORENBROT, JAMES R. GREEN, and RUSSELL K. LAROS. "Management of Term Breech Presentation." Obstetrical & Gynecological Survey 42, no. 11 (November 1987): 688. http://dx.doi.org/10.1097/00006254-198711000-00009.

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FLANAGAN, TRACY A., KRISTI M. MULCHAHEY, CAROL C. KORENBROT, JAMES R. GREEN, and RUSSELL K. LAROS. "Management of Term Breech Presentation." Obstetrical & Gynecological Survey 42, no. 11 (November 1987): 688–90. http://dx.doi.org/10.1097/00006254-198711000-00010.

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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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Toijonen, Anna E., Seppo T. Heinonen, Mika V. M. Gissler, and Georg Macharey. "A comparison of risk factors for breech presentation in preterm and term labor: a nationwide, population-based case–control study." Archives of Gynecology and Obstetrics 301, no. 2 (November 18, 2019): 393–403. http://dx.doi.org/10.1007/s00404-019-05385-5.

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Abstract Purpose To determine if the common risks for breech presentation at term labor are also eligible in preterm labor. Methods A Finnish cross-sectional study included 737,788 singleton births (24–42 gestational weeks) during 2004–2014. A multivariable logistic regression analysis was used to calculate the risks of breech presentation. Results The incidence of breech presentation at delivery decreased from 23.5% in pregnancy weeks 24–27 to 2.5% in term pregnancies. In gestational weeks 24–27, preterm premature rupture of membranes was associated with breech presentation. In 28–31 gestational weeks, breech presentation was associated with maternal pre-eclampsia/hypertension, preterm premature rupture of membranes, and fetal birth weight below the tenth percentile. In gestational weeks 32–36, the risks were advanced maternal age, nulliparity, previous cesarean section, preterm premature rupture of membranes, oligohydramnios, birth weight below the tenth percentile, female sex, and congenital anomaly. In term pregnancies, breech presentation was associated with advanced maternal age, nulliparity, maternal hypothyroidism, pre-gestational diabetes, placenta praevia, premature rupture of membranes, oligohydramnios, congenital anomaly, female sex, and birth weight below the tenth percentile. Conclusion Breech presentation in preterm labor is associated with obstetric risk factors compared to cephalic presentation. These risks decrease linearly with the gestational age. In moderate to late preterm delivery, breech presentation is a high-risk state and some obstetric risk factors are yet visible in early preterm delivery. Breech presentation in extremely preterm deliveries has, with the exception of preterm premature rupture of membranes, similar clinical risk profiles as in cephalic presentation.
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Vedpathak, Sachin G., Vaishali R. Korde Nayak, and Panigrahi P. P. "Outcome of external cephalic version (ECV) in singleton pregnancy with uncomplicated breech presentation at term in a tertiary rural hospital." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 8 (July 26, 2017): 3528. http://dx.doi.org/10.18203/2320-1770.ijrcog20173477.

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Background: Breech presentation is the most common malpresentation. The incidence of breech presentation at term is 3-4%. Objective of present study was to evaluate the outcome of external cephalic version (ECV) in singleton pregnancy with uncomplicated breech presentation at term in tertiary rural hospital and to analyze the immediate and ultimate outcome of external cephalic version done in term pregnancy with breech presentation with gestational age ≥37 weeks.Methods: This study was conducted at MIMER Medical college and BSTR Hospital, Talegaon Dabhade. Patients with breech presentation at term were studied over duration of 2½ years. 50 patients with breech presentation ≥37 weeks fulfilling the inclusion criteria underwent External cephalic version (ECV). Further obstetric progress is studied with the perinatal outcome and results were analyzed.Results: ECV was successful in 66% cases, out of which 88% cases had vaginal delivery and 12 % cases had LSCS for obstetric indication. Perinatal outcome was not affected with ECV.Conclusions: ECV at term significantly reduces both the incidence of breech delivery and caesarean section rate for breech delivery. ECV does not adversely affect the maternal and perinatal outcome.
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Jennewein, Lukas, Simon Theissen, Hemma Roswitha Pfeifenberger, Nadja Zander, Kyra Fischer, Christine Eichbaum, and Frank Louwen. "Differences in Biometric Fetal Weight Estimation Accuracy and Doppler Examination Results in Uncomplicated Term Singleton Pregnancies between Vertex and Breech Presentation." Journal of Clinical Medicine 10, no. 15 (July 23, 2021): 3252. http://dx.doi.org/10.3390/jcm10153252.

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Doppler examination of the umbilical artery and the fetal middle cerebral artery is evaluated predominantly in pregnancies with fetuses in cephalic presentation and never has been elucidated in breech presentation. Evidence on the accuracy of fetal weight estimation in dependence of the fetal presentation is controversial. Nevertheless, clinical decisions including recommendations for a cesarean section or labor induction based on these examinations are applied to pregnancies with fetuses in breech presentation. The objective of this study was to investigate the influence of the fetal presentation on fetal weight estimation accuracy, umbilical artery and middle cerebral artery resistance indices (RI) in a prospective case control study. Ultrasound examinations in 305 uncomplicated term pregnancies (153 vertex presentations, 152 breech) were investigated. Non-parametric variables were compared using Pearson’s chi2 test and Wilcoxon chi2 test, depending on variable scaling. Fetal weight estimation accuracy was not significantly different between vertex presentation group (VP) (6.97%) and breech presentation group (BP) (7.96%, p = 0.099). Fetal head circumference measurements were significantly larger in BP (350 mm vs. 341 mm in VB, p > 0.0001) while abdominal circumferences were significantly smaller (VP: 338 mm, BP: 331 mm, p = 0.0039) and weight estimation was not significantly different. Umbilical artery RIs were not significantly different between VP (54.5) and BP (55.3, p = 0.354). Fetal middle cerebral artery RIs also showed no significant differences (VP: 71.2, BP: 70.7, p = 0.335). Our study shows that fetal Doppler (RI) and weight estimation ultrasound originally calibrated in cephalic pregnancies are applicable to pregnancies with fetuses in breech presentation.
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Sekulić, Slobodan R., Đorde S. Petrović, Radmila Runić, Mark Williams, and Tihomir R. Vejnović. "Does a Probability of Breech Presentation of More Than 50% Exist Among Diseases and Medical Conditions?" Twin Research and Human Genetics 10, no. 4 (August 1, 2007): 649–54. http://dx.doi.org/10.1375/twin.10.4.649.

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AbstractThe aim was to study the effect of twin gestations in a uterus with 2 bodies on the probability of breech presentation at delivery. The hypothesis was that the probability of breech presentation was not higher than 50%. A review was undertaken of MEDLINE (1966–2004) and of the article reference list for statistical analysis of presentation at delivery among twins in a normal uterus, singleton gestations in a uterus with 2 bodies, and case studies of twins in a uterus with 2 bodies. There are 10 studies of twin gestations in a normal uterus (Twin A 3036 cases, breech presentation 22.36%; Twin B 2758 cases, breech presentation 36.87%), 2 studies of singleton gestations in a uterus with 2 bodies (297 cases, breech presentation 42.09%), and 57 case report studies of twin gestations in a uterus with 2 bodies (Twin A 56 cases, breech presentation 14.29%; Twin B 54 cases, breech presentation 18.52%). The odds ratio and chi-square test for differences in probabilities show a significantly lower incidence of breech presentation for twins in a uterus with 2 bodies compared with twins in a normal uterus (Twin A, odds ratio = 0.58; χ2 = 2.08, p > .05, Twin B, odds ratio = 0.39, χ2 = 7.67, p < .05), and singleton gestations in a uterus with 2 bodies (Twin A, odds ratio = 0.23, χ2 = 15.51, p < .05; Twin B, odds ratio = 0.31, χ2 = 10.72, p < .05). Twin gestations in a uterus with 2 bodies decrease the probability of breech presentation.
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Salim, Ibtisam, Eleonora Staines-Urias, Sam Mathewlynn, Lior Drukker, Manu Vatish, and Lawrence Impey. "The impact of a routine late third trimester growth scan on the incidence, diagnosis, and management of breech presentation in Oxfordshire, UK: A cohort study." PLOS Medicine 18, no. 1 (January 15, 2021): e1003503. http://dx.doi.org/10.1371/journal.pmed.1003503.

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Background Breech presentation at term contributes significantly to cesarean section (CS) rates worldwide. External cephalic version (ECV) is a safe procedure that reduces term breech presentation and associated CS. A principal barrier to ECV is failure to diagnose breech presentation. Failure to diagnose breech presentation also leads to emergency CS or unplanned vaginal breech birth. Recent evidence suggests that undiagnosed breech might be eliminated using a third trimester scan. Our aim was to evaluate the impact of introducing a routine 36-week scan on the incidence of breech presentation and of undiagnosed breech presentation. Methods and findings We carried out a population-based cohort study of pregnant women in a single unit covering Oxfordshire, United Kingdom. All women delivering between 37+0 and 42+6 weeks gestational age, with a singleton, nonanomalous fetus over a 4-year period (01 October 2014 to 30 September 2018) were included. The mean maternal age was 31 years, mean BMI 26, 44% were nulliparous, and 21% were of non-white ethnicity. Comparisons between the 2 years before and after introduction of routine 36-week scan were made for 2 primary outcomes of (1) the incidence of breech presentation and (2) undiagnosed breech presentation. Secondary outcomes related to ECV, mode of birth, and perinatal outcomes. Relative risks (RRs) with 95% confidence intervals (CIs) are reported. A total of 27,825 pregnancies were analysed (14,444 before and 13,381 after). A scan after 35+0 weeks was performed in 5,578 (38.6%) before, and 13,251 (99.0%) after (p < 0.001). The incidence of breech presentation at birth did not change significantly (2.6% and 2.7%) (RR 1.02; 95% CI 0.89, 1.18; p = 0.76). The rate of undiagnosed breech before labour reduced, from 22.3% to 4.7% (RR 0.21; 95% CI 0.12, 0.36; p < 0.001). Vaginal breech birth rates fell from 10.3% to 5.3% (RR 0.51; 95% CI 0.30, 0.87; p = 0.01); nonsignificant increases in elective CS rates and decreases in emergency CS rates for breech babies were seen. Neonatal outcomes were not significantly altered. Study limitations include insufficient numbers to detect serious adverse outcomes, that we cannot exclude secular changes over time which may have influenced our results, and that these findings are most applicable where a comprehensive ECV service exists. Conclusions In this study, a universal 36-week scan policy was associated with a reduction in the incidence but not elimination of undiagnosed term breech presentation. There was no reduction in the incidence of breech presentation at birth, despite a comprehensive ECV service.
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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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Majeed, Noreen, Shabana Kalsoom, Faiza Safdar, Shazia Rafique, Shamsa Tariq, and Saana Bibi. "To determine the rate of success of external cephalic version in low risk breech presentations and possible factors affecting its success in POF hospital, Wah Cantt." Journal of Rawalpindi Medical College 25, no. 2 (June 30, 2021): 186–91. http://dx.doi.org/10.37939/jrmc.v25i2.1507.

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Abstract Background The caesarean section rate is on the rise for various reasons. One of the reason is breech presentation . External cephalic version is a procedure to manipulate the baby from breech to cephalic presentation externally through the maternal abdomen under USG guidance . Success in ECV decreases the breech presentation and hence caesarean section rate . Methods This retrospective study was conducted by Wah Medical College in POF hospital from10 Oct 2015- 10 Oct 2019 after approval from the ethical committee . It included 56 low risk singleton breech presentations from 36 wks- 40 wks after taking their informed consent While those with < than 36 wks (primis) and >40 wks gestation, refusal to ECV , with absolute contraindication to ECV& with medical and obstetric complications (ie scarred uterus, liquor <than 8 cm & > than 17 cm, fetal growth restriction, preclampsia, gestational diabetes & abnormal cardiotocography) were excluded from the study. ECV was performed by single obstetrician in labour room with facilities of cardiotocograph and emergency caesarean section. Cardiotocography of the fetus for 30-40 min was done just before & after the procedure of ECV. ECV was declared successful on cofirming head of the fetus occupying the lower uterine segment on ultrasound. .Number of successful ECVs & specific factors of the women & the baby (age . parity, amniotic fluid index ,type of breech, engagement of breech, position of back of baby) were chosen to observe their effect on success of ECV. Results External cephalic version was successful in 27 (48.2%) & unsuccessful in 29 (51.8%)of women .Multiparity , unengaged breech & type of breech (complete flexed) ( with p values .001, .000 & .001 respectively) had statistically significant positive association with successful external cephalic version. Conclusion ECV should be offered to all women with low risk breech presentations. Knowledge of factors predictive of ECV success can be utilized in selecting cases for ECV &counselling the women regarding the success and failure of ECV.
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48

Laurentiu, Tomescu Cezar, Rodica Sîrbu, Emin Cadar, Brezeanu Dragos, and Aneta Tomescu. "Breech Presentation: Vaginal Delivery or Caesarean Section?" European Journal of Interdisciplinary Studies 2, no. 1 (April 30, 2016): 153. http://dx.doi.org/10.26417/ejis.v2i1.p153-157.

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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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49

Laurentiu, Tomescu Cezar, Rodica Sîrbu, Emin Cadar, Brezeanu Dragos, and Aneta Tomescu. "Breech Presentation: Vaginal Delivery or Caesarean Section?" European Journal of Interdisciplinary Studies 4, no. 1 (April 30, 2016): 153. http://dx.doi.org/10.26417/ejis.v4i1.p153-157.

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Abstract:
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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50

Padmavathi, T., and Aruna. "STUDY OF PERINATAL MORTALITY IN TERM BREECH PRESENTATION WITH INCREASING CAESAREAN SECTION RATE." International Journal of Research -GRANTHAALAYAH 5, no. 2 (February 28, 2017): 59–66. http://dx.doi.org/10.29121/granthaalayah.v5.i2.2017.1703.

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Breech presentation persists in 3-4% of all term deliveries. There is a threefold increase in perinatal mortality for breech infant delivered vaginally which is related to birth asphyxia and birth trauma. The most frequent cause of death in neonates delivered through breech is intracranial hemorrhage; so many obstetricians recommend caesarean section for breech presentation. It is a retrospective study regarding management of term breech presentation conducted in King George Hospital, Vishakhapatnam from 2012 to 2015 and the results are compared with a similar study conducted in 1981-1984.There is an increase in incidence of caesarean section and decrease in perinatal mortality in our present study when compared to previous study. Increase in caesarean section for breech delivery has decreased the overall incidence of perinatal mortality.
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