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Comparison of fetal outcome in premature vaginal or cesarean breech delivery at 24-37 gestational weeks.
Arch Gynecol Obstet. 2014 Aug; 290(2):271-81.AG

Abstract

PURPOSE

To compare the fetal outcome of preterm breech infants delivered vaginally (VD) or by cesarean section (CS).

METHODS

A monocentric, retrospective consecutive case series of preterm breech deliveries between 24-37 gestational weeks over 10 years from 1/2000 to 12/2009 was performed in a perinatal care center (Level 1) at the University Clinic of Salzburg, Austria. Data from hospital database were statistically analyzed and compared regarding birth weight, head circumference, parity, transfer rate to neonatal intensive care unit (NICU), arterial and venous cord blood pH and base excess (BE), arterial cord blood pH ≤ 7.10 and BE ≤ -11. Special focus was on fetal outcome of elective CS preterm breech deliveries with a non-urgent medical indication compared to VD.

RESULTS

Among 22.115 deliveries, there were 346 live-born preterm singletons and twins in breech presentation (1.56 %), born between 24 + 0 and 37 + 0 gestational weeks. 180 CS and 36 vaginally delivered preterm breech infants were statistically evaluated. On comparing CS vs. VD for premature breech singletons, arterial cord blood pH and BE were lower in the VD group. VD twins had a lower arterial cord blood pH than CS twins. All other parameters were comparable. In preterm breech singletons with non-urgent CS, a statistical analysis was not possible due to small numbers. The VD twin group revealed lower values in birth weight, head circumference, arterial cord blood pH and BE, but no significant difference in venous cord blood pH and BE and transfer rate to NICU.

CONCLUSIONS

Although general recommendations regarding a superior mode of delivery for improved fetal outcome of preterm breech infants cannot be given, these data do not support a policy of routine CS.

Authors+Show Affiliations

Paracelsus Medical University (PMU), Müllner Hauptstr. 48, 5020, Salzburg, Austria.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

24668252

Citation

Vidovics, Mia, et al. "Comparison of Fetal Outcome in Premature Vaginal or Cesarean Breech Delivery at 24-37 Gestational Weeks." Archives of Gynecology and Obstetrics, vol. 290, no. 2, 2014, pp. 271-81.
Vidovics M, Jacobs VR, Fischer T, et al. Comparison of fetal outcome in premature vaginal or cesarean breech delivery at 24-37 gestational weeks. Arch Gynecol Obstet. 2014;290(2):271-81.
Vidovics, M., Jacobs, V. R., Fischer, T., & Maier, B. (2014). Comparison of fetal outcome in premature vaginal or cesarean breech delivery at 24-37 gestational weeks. Archives of Gynecology and Obstetrics, 290(2), 271-81. https://doi.org/10.1007/s00404-014-3203-y
Vidovics M, et al. Comparison of Fetal Outcome in Premature Vaginal or Cesarean Breech Delivery at 24-37 Gestational Weeks. Arch Gynecol Obstet. 2014;290(2):271-81. PubMed PMID: 24668252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of fetal outcome in premature vaginal or cesarean breech delivery at 24-37 gestational weeks. AU - Vidovics,Mia, AU - Jacobs,Volker R, AU - Fischer,Thorsten, AU - Maier,Barbara, Y1 - 2014/03/26/ PY - 2013/11/06/received PY - 2014/02/28/accepted PY - 2014/3/27/entrez PY - 2014/3/29/pubmed PY - 2014/10/4/medline SP - 271 EP - 81 JF - Archives of gynecology and obstetrics JO - Arch Gynecol Obstet VL - 290 IS - 2 N2 - PURPOSE: To compare the fetal outcome of preterm breech infants delivered vaginally (VD) or by cesarean section (CS). METHODS: A monocentric, retrospective consecutive case series of preterm breech deliveries between 24-37 gestational weeks over 10 years from 1/2000 to 12/2009 was performed in a perinatal care center (Level 1) at the University Clinic of Salzburg, Austria. Data from hospital database were statistically analyzed and compared regarding birth weight, head circumference, parity, transfer rate to neonatal intensive care unit (NICU), arterial and venous cord blood pH and base excess (BE), arterial cord blood pH ≤ 7.10 and BE ≤ -11. Special focus was on fetal outcome of elective CS preterm breech deliveries with a non-urgent medical indication compared to VD. RESULTS: Among 22.115 deliveries, there were 346 live-born preterm singletons and twins in breech presentation (1.56 %), born between 24 + 0 and 37 + 0 gestational weeks. 180 CS and 36 vaginally delivered preterm breech infants were statistically evaluated. On comparing CS vs. VD for premature breech singletons, arterial cord blood pH and BE were lower in the VD group. VD twins had a lower arterial cord blood pH than CS twins. All other parameters were comparable. In preterm breech singletons with non-urgent CS, a statistical analysis was not possible due to small numbers. The VD twin group revealed lower values in birth weight, head circumference, arterial cord blood pH and BE, but no significant difference in venous cord blood pH and BE and transfer rate to NICU. CONCLUSIONS: Although general recommendations regarding a superior mode of delivery for improved fetal outcome of preterm breech infants cannot be given, these data do not support a policy of routine CS. SN - 1432-0711 UR - https://www.unboundmedicine.com/medline/citation/24668252/Comparison_of_fetal_outcome_in_premature_vaginal_or_cesarean_breech_delivery_at_24_37_gestational_weeks_ L2 - https://dx.doi.org/10.1007/s00404-014-3203-y DB - PRIME DP - Unbound Medicine ER -