Risk factors and outcomes in “well-selected” vaginal breech deliveries: a retrospective observational study

Georg Macharey; Veli-Matti Ulander; Seppo Heinonen; Karel Kostev; Mika Nuutila; Mervi Väisänen-Tommiska

doi:10.1515/jpm-2015-0342

Article

Risk factors and outcomes in “well-selected” vaginal breech deliveries: a retrospective observational study

Georg Macharey , Veli-Matti Ulander , Seppo Heinonen , Karel Kostev , Mika Nuutila and Mervi Väisänen-Tommiska

Published/Copyright: April 6, 2016

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From the journal Journal of Perinatal Medicine Volume 45 Issue 3

Abstract

Objective:

To assess risk factors for adverse perinatal and neonatal outcomes in “well-selected” singleton vaginal breech deliveries at term.

Methods:

During the time span from January 2008 up to April 2015 a total of 786 singleton term breech deliveries with a planned vaginal delivery were identified in a retrospective observational study at Helsinki University Central Hospital, Finland. The study’s end point was a composite of adverse perinatal and neonatal outcomes. Infants with an adverse outcome were compared to all spontaneous singleton vaginal breech deliveries with normal perinatal and neonatal outcomes. A multivariate logistic regression model was used to analyze associations between adverse neonatal outcomes and several variables. The secondary outcome was the severe morbidity rate according to the criteria of the term breech trial.

Results:

An adverse neonatal outcome was recorded for 38 (4.8%) infants. According to the study the second delivery stage lasting <40 min [adjusted odds ratio (aOR): 0.34, 95% confidence interval (95% CI): 0.15–0.79] was associated with lower odds and had a protective effect against adverse outcomes. Epidural anesthesia (aOR: 2.88, 95% CI: 1.08–7.70) was associated with higher adverse outcomes. The incidence rate of severe morbidity was 1.3% (10/787).

Conclusion:

Adverse neonatal outcomes in well-selected breech deliveries are associated with a prolonged second delivery stage lasting >40 min and with epidural anesthesia.

Keywords: Breech delivery; cesarean section; neonatal morbidity; neonatal mortality; perinatal morbidity; perinatal mortality

Corresponding author: Georg Macharey, MD, Department of Obstetrics and Gynecology, Helsinki University and Helsinki University Central Hospital, Haartmaninkatu 2, 00029 Helsinki, Finland, Fax: +35 850 427 1357

Conflict of interest statement: The authors state that they have full control of all primary data and they agree to allow the Journal to review their data if requested.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2015-10-4

Accepted: 2016-2-29

Published Online: 2016-4-6

Published in Print: 2017-4-1

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Articles in the same Issue

https://doi.org/10.1515/jpm-2015-0342

Keywords for this article

Breech delivery; cesarean section; neonatal morbidity; neonatal mortality; perinatal morbidity; perinatal mortality