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Breech presentation

Paola Algeri, Clelia Callegari, Davide Paolo Bernasconi, Maddalena Incerti, Sabrina Cozzolino, Giuseppe Paterlini, Salvatore Andrea Mastrolia, Francesca Pellizzoni, Patrizia Vergani
OBJECTIVE: Optimal management of twin deliveries is controversial. We aimed to assess potential risk factors correlated to the development of hypoxia in the second twin after vaginal delivery of the first twin. STUDY DESIGN: This is a retrospective observational study including diamniotic twin pregnancies delivering at our Institution at 35 weeks of gestational age or more, weighing ≥ 1800 g. Hypoxia was defined as at least one of the following: Apgar score < 5 at 10', neonatal resuscitation for > 10 minutes, neonatal acidosis (pH ≤ 7 and/or BE ≥ 12 mmol/L)...
March 11, 2018: Journal of Maternal-fetal & Neonatal Medicine
Marina Gomes, Vera Trocado, Mariana Carlos-Alves, Diana Arteiro, Paula Pinheiro
Non-pulsatile oxytocin given during labour can negatively affect breastfeeding. The aim of this study was to assess whether intrapartum oxytocin administration has any effect on breastfeeding. Secondly, to assess whether some maternal or neonatal variables influence breastfeeding. A retrospective cohort study was done, comparing two groups: women exposed (n = 101) and not exposed to oxytocin (n = 100) during labour. Women with caesarean section, vacuum extraction/forceps, twin pregnancy, breech presentation, premature neonates and with an Apgar score <7 at 5 minutes were excluded...
March 9, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Julien Chevreau, Arthur Foulon, Osama Abou, Marion Luisin, Camille Parent, Fabrice Sergent, Jean Gondry
INTRODUCTION: Breech presentation and twin pregnancy are regarded as stressful situations for medical staff. This stress is often associated with an increased likelihood of intervention during labor - especially when the on-shift obstetrician lacks experience. MATERIAL AND METHODS: We performed a 2-year prospective, observational study of cesarean section (CSDs) and assisted vaginal (AVDs) deliveries in a tertiary maternity unit for attempted vaginal deliveries of breech presentations and twin pregnancies...
March 3, 2018: Journal of Gynecology Obstetrics and Human Reproduction
M Lucovnik, I Blajic, I Verdenik, T Mirkovic, T Stopar Pintaric
BACKGROUND: The Ten Group Classification System (TGCS) allows critical analysis according to the obstetric characteristics of women in labor: singleton or multiple pregnancy, nulliparous, multiparous, or multiparous with a previous cesarean delivery, cephalic, breech presentation or other malpresentation, spontaneous or induced labor, and term or preterm births. Labor outcomes associated with epidural analgesia may be different among the different labor classification groups. The aim of this study was to explore associations between epidural analgesia and cesarean delivery, and epidural analgesia and assisted vaginal delivery, in women classified using the TGCS...
February 28, 2018: International Journal of Obstetric Anesthesia
Sonja Wehberg, Rikke Guldberg, Kim Oren Gradel, Ulrik Schiøler Kesmodel, Lis Munk, Charlotte Brix Andersson, Line Riis Jølving, Jan Nielsen, Bente Mertz Nørgård
OBJECTIVES: The aim of this study was to estimate the effects of risk factors on elective and emergency caesarean section (CS) and to estimate the between-hospital variation of risk-adjusted CS proportions. DESIGN: Historical registry-based cohort study. SETTINGS AND PARTICIPANTS: The study was based on all singleton deliveries in hospital units in Denmark from January 2009 to December 2012. A total of 226 612 births by 198 590 mothers in 29 maternity units were included...
February 10, 2018: BMJ Open
Thomas Schmitz, Diane Korb, Catherine Battie, Anne-Gaël Cordier, Céline De Carne Carnavalet, Céline Chauleur, Véronique Equy, Bassam Haddad, Delphine Lemercier, Christophe Poncelet, Luc Rigonnot, François Goffinet
BACKGROUND: Management of non-cephalic second twin delivery rests on the results of population-based retrospective studies of twin births that have shown higher neonatal mortality and morbidity for second twins with non-cephalic, compared with cephalic, presentations after vaginal delivery of the first twin. Because these studies are flawed by data of questionable validity, do not report the obstetrical practices at delivery and do not allow collection of potential confounding variables, we performed a national prospective study specially designed to evaluate the management of twins' delivery...
January 17, 2018: American Journal of Obstetrics and Gynecology
Wen Sun, Fen Liu, Shiliang Liu, Sara-Michelle Gratton, Darine El-Chaar, Shi Wu Wen, Dunjin Chen
OBJECTIVES: Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity. METHODS: Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included...
March 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Folashade Olufunke Omokhodion, Olumuyiwa Adebola Roberts, Modupe Onayinka Onadeko, Jeremy Richard Beach, Nicola Cherry, Igor Burstyn
Little information exists about socio-economic, environmental or occupational determinants of low Apgar scores among Nigerian neonates. Mothers in lying-in wards of four hospitals in Ibadan were interviewed on socio-demographic characteristics, obstetric history and work activities during index pregnancy. Apgar scores and clinical data were extracted from case notes. Of the 1349 respondents, 20% had Apgar score <7 at one minute, 4% at five minutes. Lower education, cooking with kerosene, physical exertion at work, nulliparity, hypertension in pregnancy, prolonged rupture of membranes, breech presentation and caesarean section were predictors for low Apgar scores at one minute; nulliparity, male infant and breech presentation at five minutes...
February 1, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Daniel W Robinson, Michael Anana, Mary A Edens, Marc Kanter, Sorabh Khandelwal, Kaushal Shah, Todd Peterson
Introduction: Obstetrical emergencies are a high-risk yet infrequent occurrence in the emergency department. While U.S. emergency medicine (EM) residency graduates are required to perform 10 low-risk normal spontaneous vaginal deliveries, little is known about how residencies prepare residents to manage obstetrical emergencies. We sought to profile the current obstetrical training curricula through a survey of U.S. training programs. Methods: We sent a web-based survey covering the four most common obstetrical emergencies (pre-eclampsia/eclampsia, postpartum hemorrhage (PPH), shoulder dystocia, and breech presentation) through email invitations to all program directors (PD) of U...
January 2018: Western Journal of Emergency Medicine
Hannes Kubo, Hakan Pilge, Karoline Nepp, Bettina Westhoff, Ruediger Krauspe
INTRODUCTION: Early diagnosis and treatment of hip dysplasia are widely accepted as major factors for beneficial outcome. However, modalities for reduction and retention as well as for imaging are currently under clinical investigation. Local and general risk factors, e.g., breech presentation and the family's desire to avoid in-hospital treatment are major concerns in the decision-making process and consultation. For treatment of unstable hips in newborns the treatment with the Tübingen splint has proven good results in recent studies...
January 19, 2018: Archives of Orthopaedic and Trauma Surgery
Jérôme M J Cornette, Jan S Erkamp
BACKGROUND: Experience with internal podalic version and breech extraction is diminishing, especially in the younger generation of obstetricians. Simulation training is essential to teach and maintain these skills. INSTRUMENT: We present a mannequin-based simulation method that enhances realistic sensations during training. EXPERIENCE: By positioning the fetal mannequin into a thin plastic bag filled with water, the impression of palpating, grabbing, and pulling the fetal feet through the plastic bag is similar to reaching feet through intact membranes...
January 9, 2018: Obstetrics and Gynecology
Sophie Janet, Verena I Carrara, Julie A Simpson, Nant War War Thin, Wah Wah Say, Naw Ta Mlar Paw, Kesinee Chotivanich, Claudia Turner, Jane Crawley, Rose McGready
BACKGROUND: Of the 4 million neonatal deaths worldwide yearly, 98% occur in low and middle-income countries. Effective resuscitation reduces mortality and morbidity but long-term outcomes in resource-limited settings are poorly described. This study reports on newborn neurological outcomes following resuscitation at birth in a resource-limited setting where intensive newborn care including intubation is unavailable. METHODS: Retrospective analysis of births records from 2008 to 2015 at Shoklo Malaria Research Unit (SMRU) on the Thailand-Myanmar border...
2018: PloS One
Amir R Vafaee, Taghi Baghdadi, Azarakhsh Baghdadi, Reza Khalili Jamnani
Background: Although the developmental dysplasia of the hip (DDH) is well known to pediatric orthopedists, its etiology has still remained unknown and despite dedication of a vast majority of research, the results are still inadequate and confusing. The exact incidence of DDH and its relationship with known risk factors in Iran is still unknown. Here we represent the results of one year study on the incidence and related conditions of DDH. Methods: Sonography was performed on the hip joints of 1073 full term healthy newborns at Imam Khomeini Hospital from March 2013 to March 2014...
November 2017: Archives of Bone and Joint Surgery
P Blanc-Petitjean, M Salomé, C Dupont, C Crenn-Hebert, A Gaudineau, F Perrotte, P Raynal, E Clouqueur, G Beucher, B Carbonne, F Goffinet, C Le Ray
INTRODUCTION: In 2016, 22.0% of deliveries in France were induced. The current lack of high level of evidence data about the methods and indications for induction of labour has promoted heterogeneous and non-recommended practices. The extent of these different practices is not adequately known in France today, although they may influence perinatal outcomes. The objective of this study was to report current practices of induction of labour in France. MATERIAL AND METHODS: This study surveyed 94 maternity units in seven perinatal networks...
February 2018: Journal of Gynecology Obstetrics and Human Reproduction
Ishaan Swarup, Caitlin L Penny, Emily R Dodwell
PURPOSE OF REVIEW: Our understanding of the epidemiology, diagnosis, and management of developmental dysplasia of the hip (DDH) is evolving. This review focuses on the most up-to-date literature on DDH in patients from birth to six months of age. RECENT FINDINGS: Well known risk factors for DDH include family history, female sex, and breech positioning. Recent evidence suggests higher birth weight is a risk, whereas prematurity may be protective. Screening includes physical examination of all infant hips and imaging when abnormal findings or risk factors are present...
February 2018: Current Opinion in Pediatrics
Kirsten M Niles, Jon F R Barrett, Noor Niyar N Ladhani
OBJECTIVE: As survival increases at earlier gestational ages, the optimal mode of delivery, especially in cases of breech presentation, is of increasing importance. The objective of this study was to compare outcomes of vaginal delivery (VD) and cesarean section (CS) births for infants in breech presentation at borderline viability. STUDY DESIGN: A retrospective chart review of live breech births between 23 + 0 and 25 + 6 weeks gestation at a tertiary university center from 2003 to 2013 was conducted...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
April A Bice
Pediatric nurses have often reported that pain management is a vital part of patient care. Evidence, however, suggests pediatric procedural pain treatments are often underused. Cognitive dissonance, the mental conflict leading to unpleasant thoughts and or feelings, may be related to this evidence-based gap found between what pediatric nurses claim about procedural pain management (that it is important) and what they actually do (underutilize pain treatments). The purpose of this manuscript is to clarify and further develop the concept of cognitive dissonance in terms of its relationship to nurses' mental struggles with underutilization of pediatric procedural pain treatments...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Rong Zhao, Xin Wang, Liying Zou, Guanghui Li, Yi Chen, Changdong Li, Weiyuan Zhang
OBJECTIVE: To estimate the association between uterine fibroids and adverse obstetric outcomes. METHODS: This was a retrospective cross-sectional study of 112,403 deliveries from 14 provinces and 39 different hospitals in 2011 in mainland China. We compared pregnancy outcomes in women with and without uterine fibroids who underwent detailed second trimester obstetric ultrasonography during 18 to 22 weeks. Obstetric outcomes include cesarean delivery, breech presentation, preterm delivery, placenta previa, placental abruption, premature rupture of membranes and neonatal birthweight...
2017: PloS One
Keith B Morris, Eric F Law, Roger L Jefferys, Elizabeth C Dearth, Emily B Fabyanic
Through analysis and comparison of firing pin, breech face, and ejector impressions, where appropriate, firearm examiners may connect a cartridge case to a suspect firearm with a certain likelihood in a criminal investigation. When a firearm is not present, an examiner may use the Integrated Ballistics Identification System (IBIS(®)), an automated search and retrieval system coupled with the National Integrated Ballistics Information Network (NIBIN), a database of images showing the markings on fired cartridge cases and bullets from crime scenes along with test fired firearms...
October 14, 2017: Forensic Science International
Simone M Kuppens, Ida Smailbegovic, Saskia Houterman, Ingrid de Leeuw, Tom H Hasaart
BACKGROUND: Fetal heart rate abnormalities (FHR) during and after external cephalic version (ECV) are relatively frequent. They may raise concern about fetal wellbeing. Only occasionally they may lead to an emergency cesarean section. METHODS: Prospective cohort study in 980 women (> 34 weeks gestation) with a singleton fetus in breech presentation. During and after external cephalic version (ECV) FHR abnormalities were recorded. Obstetric variables and delivery outcome were evaluated...
October 17, 2017: BMC Pregnancy and Childbirth
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