Influence of mode of delivery on neonatal mortality and morbidity in spontaneous preterm breech delivery (original) (raw)
Related papers
Risk factors for adverse outcomes in vaginal preterm breech labor
Archives of Gynecology and Obstetrics
Purpose To assess the risk factors for adverse outcomes in attempted vaginal preterm breech deliveries. Methods A retrospective case–control study, including 2312 preterm breech deliveries (24 + 0 to 36 + 6 gestational weeks) from 2004 to 2018 in Finland. The preterm breech fetuses with adverse outcomes born vaginally or by emergency cesarean section were compared with the fetuses without adverse outcomes with the same gestational age. A multivariable logistic regression analysis was used to calculate the risk factors for adverse outcomes (umbilical arterial pH below 7, 5-min Apgar score below 4, intrapartum stillbirth and neonatal death
Subsequent pregnancy outcome after preterm breech delivery, a population based cohort study
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
Objective To investigate the effect of the mode of delivery in women with preterm breech presentation on neonatal and maternal outcome in the subsequent pregnancy. Methods Nationwide population based cohort study in the Netherlands of women with a preterm breech delivery and a subsequent delivery in the years 1999 to 2007. We compared planned caesarean section versus planned vaginal delivery for perinatal outcomes in both pregnancies. Results We identified 1,543 women in the study period, of whom 259 (17%) women had a planned caesarean section and 1,284 (83%) women had a planned vaginal delivery in the first pregnancy. In the subsequent pregnancy, perinatal mortality was 1.1% (3/259) for women with a planned caesarean section in the first pregnancy and 0.5% (6/1284) for women with a planned vaginal delivery in the first pregnancy, (aOR 1.8; 95% CI 0.31-10.1). Composite adverse neonatal outcome was 2.3% (6/259) versus 1.5% (19/1284), (aOR 1.5; 95% CI 0.55-4.2). The average risk of perinatal mortality over two pregnancies was 1.9% (10/518) for planned caesarean section and 2.0% (51/2568) for planned vaginal delivery, (OR 0.98; 95% CI 0.49-1.9). Conclusion In women with a preterm breech delivery planned caesarean section does not reduce perinatal mortality, perinatal morbidity or maternal morbidity rate over the course of two pregnancies.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2019
HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. Distributed under a Creative Commons Attribution-NonCommercial| 4.0 International License
Moderate neonatal morbidity after vaginal term breech delivery
Journal of Maternal-Fetal and Neonatal Medicine, 2004
Objective: Comparison of the results of term breech births in our clinic with the Term Breech Trial (TBT). Material and Methods: During the investigation period prospective data were collected on all deliveries of a term baby in breech presentation. Some pregnant women were included in the TBT and randomized in a planned cesarean section (CS)-group and a planned vaginal birth (VB)-group. The remaining non-randomized women were divided into a primary CS-group and a started VBgroup. Neonatal and maternal mortality and morbidity were analyzed retrospectively, according to the intended mode of delivery. Results: Neonatal or maternal mortality occurred in none of the groups. Neither in the randomized group nor in the non-randomized group were significant differences in serious neonatal and maternal morbidity observed between the intended cesarean section-group and the group that started vaginal delivery. However, in the non-randomized group, moderate neonatal morbidity was significantly lower in the primary CS-group than in the started VB-group. Conclusion: The differences in moderate neonatal morbidity support the conclusion of the TBT, that primary cesarean section may be safer for the term breech baby than a trial of vaginal labor.
The Effect of the Cause of Delivery on Neonatal Outcomes in Early Preterm Deliveries
Journal of Fetal Medicine, 2019
The aim of this study was to evaluate the effect of causes of delivery on short-term neonatal morbidities and mortality in EPD (< 34 gestational weeks). We retrospectively analysed the deliveries occurring between 23 + 0 and 33 + 6th gestational weeks at our tertiary center during 2014–2018. A total of 290 deliveries were evaluated, and 369 newborns [singletons (56.4%), twins (36.6%) and triplets (7.1%)] were included in the study. The causes of deliveries were defined as spontaneously preterm birth (n = 107, 29%), preterm premature rupture of membranes (PPROM) (n = 131, 35.5%) or iatrogenic preterm birth (n = 131, 35.5%). The rate of neonatal respiratory distress syndrome (RDS), patent ductus arteriosus, bronchopulmonary dysplasia (BPD), intraventricular haemorrhagia (IVH), necrotising enterocolitis, retinopathy of prematurity, neonatal resuscitation, sepsis and death were similar between groups. However; neonatal RDS, BPD, IVH and sepsis were found to be higher in cases with ch...
Mode of delivery and neonatal death in 17 587 infants presenting by the breech
BJOG: An International Journal of Obstetrics and Gynaecology, 1991
Objective-To study thc effects of caesarean section on neonatal mortality in infants presenting by the breech. Design-Population-based non-experimental comparison of infants prcscnting by the breech born vaginally with those born by cacsarcan scction. Neonatal mortality rates were calculated for 250 g birthweight intervals. Weight-spccific relative risks (RRs) were further adjusted for birthweight in 50 g catcgorics. Setting-New York City, 1978-1983. Data came from the Departrncnt of Health's computerized vital records on livebirths and infant dcaths. Subjects-17 587 singleton breech livebirths 2500 g birthwcight, with congenital anomaly deaths excluded. 6178 were born vaginally and 11409 were born by caesarean section. Main outcome measures-Birthweight-specific and birthweight-adjusted neonatal mortality. Results-At birthwcights of 501 to 1750 g, the risk of neonatal dcath for breech infants born vaginally was significantly higher than the risk for those born by caesarean section (.weight-adjusted RR= 1.7). For breech infants with birthweights over 3000 g, the weight-adjustcd risk was 5.6 times greater for a vaginal birth compared with caesarean section. Thc addition of 16 additional control variables in multiple logistic rcgrcssion analyses did not change these RRs. Conclusion-Population-based studies indicatc that an increase in the caesarean section rate among breech singletons may be associatcd with increased neonatal survival, but a large multicentrc randomized trial of managemcnt of brccch presentation would answcr the question much more dcfinitivcly. This is a report of the results of an analysis o f whether babies presenting by the breech who are born vaginally arc at higher risk of neonatal mortality than those who are born by caesarean section. The data were non-expcrimental, that is, pregnant women were not randomly allocatcd to
Mode of delivery and mortality among preterm newborns
2010
OBJECTIVE The purpose of our study was to analyze the frequency of preterm deliveries in Obstetrics & Gynecology Clinic, University Clinical Centre of Kosovo, Prishtina (Republic of Kosovo), as well as to assess the survival advantage of premature newborns according to mode of delivery (cesarean section vs. vaginal). MATERIAL AND METHODS A cohort of 12,466 deliveries from the year 2002 was studied retrospectively and preterm deliveries were analyzed. Survival advantage until 28 days of life associated with cesarean and vaginal delivery was assessed with regard to birth weights (500-999 g, 1000-1499 g, 1500-1999 g, and 2000-2499 g). RESULTS There were 1,135 preterm deliveries which resulted in 1,189 preterm infants (including multiples). The overall cesarean delivery rate in this group was 32.2%. Among preterm newborns with birth weight 500-999 g, 68 children were delivered vaginally and 5 by caesarean section (5.7% and 0.4% of all preterm babies respectively). None of the infants su...
Impact of Mode of Delivery on the Neonatal and Maternal Outcomes: A Cross-Sectional Study
Pakistan Journal of Medical and Health Sciences, 2022
The patients were divided into two groups and each group included 178 women. One group had undergone cesarean section and the other group had undergone normal vaginal delivery, and different maternal and neonatal outcomes were assessed including trauma, significant loss of blood, Apgar score, puerperal febrile morbidity, wound infection, and cord pH. Results: The study observed a higher rate of puerperal febrile morbidity and wound infections present in Csection. Similarly, blood loss was also significant in C-sections. However, neonatal complications were low and non-significant between the two groups. Conclusion: The study observed that increased maternal morbidity is associated with C-sections and women must be informed properly before making a choice of delivery.
Perinatal outcome of singleton term breech deliveries
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1998
Objective: To assess neonatal morbidity and mortality in singleton term infants delivered in breech presentation and to find a possible correlation between outcome and mode of delivery. Study design: Case study of 306 singleton, term (37-42 weeks), breech deliveries, that took place between 1989 and 1994 in one perinatal centre. Results: 170 infants were delivered vaginally, 72 by elective and 64 by secondary cesarean section. Even after application of strict selection criteria -i.e. prior pelvic assessment by staff obstetricians, an estimated birth weight of 2500-4000 g -and with staff supervision, vaginal delivery turned out to be associated with a significantly higher incidence of low umbilical artery pH values and neonatal care unit admissions as compared to elective cesarean section. Five infants suffered mechanical trauma. One neonatal death occurred in the vaginal delivery group. Conclusion: The results of this retrospective study of 306 singleton term breech deliveries imply that even after strict selection of patients, vaginal delivery is associated with increased neonatal morbidity in comparison to elective cesarean section.