Childbirth with fetal pelvis presentatio: Challenge in modern obstetrics

Radenka Borlja-Mijailovic ,
Radenka Borlja-Mijailovic
Maja Skender ,
Maja Skender
Ljiljana Avramovic ,
Ljiljana Avramovic
Mirjana Pavlovic-Raicevic ,
Mirjana Pavlovic-Raicevic
Aleksandar Dukic ,
Aleksandar Dukic
Vesna Ljubic
Vesna Ljubic

Published: 01.12.2011.

Biochemistry

Volume 28, Issue 3 (2012)

pp. 665-672;

https://doi.org/10.5937/matmed1203665b

Abstract

The aim was to determine the incidence of fetal breech presentation at term, the factors that determine how the impact of labor and mode of delivery on neonatal outcome in pregnancies with a fetus in breech presentation pelvic presentation is a form of the longitudinal position of the fetus, which leads the pelvis and occurs in approximately 3% of pregnancies. Numerous studies have shown contradictory results regarding the optimal mode of delivery in breech presentation of fetus. A retrospective study at the Hospital of Gynecology and Obstetrics, University Hospital Zemun-Belgrade in the period 01.01.2009-31.12.2011 year. We analyzed data obtained from the delivery protocol, computer databases and annual reports.study involved 111 pregnant women in the forward singleton pregnancy (37-41 weeks gestation) with fetal pelvis. We analyzed and compared the group of patients who delivered their babies vaginally and the group of patients who delivered their babies by caesarean section (emergency and planned). Analyzed and compared the following parameters: maternal age, parity, gestational age tudnoće, premature rupture of membranes, weight and head circumference fetus at birth, Apgar score and neonatal complications. The data were analyzed by descriptive and analytical statistics. Results are presented tables and graphs. The study period was performed 4665 deliveries, with 111 deliveries in futures fetuses in breech presentation, which is 2.4%. Women delivered vaginally was 79(71%), emergency caesarean section 17(15%), a planned caesarean section 15(14%) pregnant women. The study showed a statistically significant difference in parity (C2=6.23 p<0, 05), with greater participation in the group of primiparas cesarean section, gestational age (t=5.23 p<0,01), weight and head circumference (t=4.37, t=2.47 p<0,01), premature rupture of membranes, (C2=7.72 p<0,01) and gender structure (C2=4.03 p<0,05). The most common indication for elective Caesarean section was prolonged pregnancy, and for an emergency cesarean section because of the delivery routes. There was no statistically significant difference in age of the mother t=1.08, p>0,05, the values of Apgar score in 5 minutes t=1.67 p>0,05, neurological changes p=0.292 and birth trauma, p=0.292 between two groups of neonates. The values of ul minute Apgar score were at the limits of statistical significance p=1.97 p≥0.05. Vaginal delivery in breech presentation, fetal, obstetric an acceptable range, while respecting the principles of good obstetric practice, there is no increase in neonatal morbidity.

Keywords

References

1.
Cheng M, Hannah M. Breech delivery at term: a critical review of the literature. Obstet Gynecol. 1993;605–18.
2.
recurrence of breech presentation in consecutive pregnancies. BjOG. 2010;830–6.
3.
Doyle N, Ma G. LC 3rd.Outcomes of term vaginal breech delivery. am j Perinatol. 2005;325–8.
4.
Ghosh M. Breech presentation: evolution of management. j reprod Med. 2005;108–16.
5.
Su M, Mcleod L, Willan. Factors associated with adverse perinatal outcome in the Term Breech Trial. am j Obstet Gynecol. 2003;740.
6.
Gj H, Hannah M. Planned caesarean section for term breech delivery. Cochrane database syst rev. 2003;
7.
Hannah M, Wj H, Hewson Sa H, Ed, Willan Ar. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Lancet. 2000;1375–83.
8.
Mishra M. does caesarean section provide the best outcome for mother and baby in breech presentation? a perspective from the developing world. am jObstet Gynecol. 2011;495–8.
9.
rCOG The Management of Breech Presentation. Guideline No. 2006;(20).
10.
aCOG Committee Opinion Mode of term singleton breech delivery. Obstetrics & Gynaecology. 2006;235–7.
11.
Goffinet F, Carayol M, Foidart. PrEMOda study Group. Is planned vaginal delivery for breech presentation at term still an option? results of an observational prospective survey in France and Belgium. am j Obstet Gynecol. 2006;1002–11.
12.
Maf, Nassar Ah, Usta I, Melhem Z, Kazma, Kallil Am. Impact of advanced maternal age on pregnancy outcome. am j Perinatol. 2002;1–7.
13.
Andrews K, Menticoglou S, Gagnon R. Vaginal delivery of breech presentation. Int j Gynecol Obstet. 2009;557–66.
14.
Mcnamara Jm, Odibo Ao M, Ga, Cahill A. The effect of breech presentation on the accuracy of estimated fetal weight. am j Perinatol. 2012;353–60.
15.
Kotaska A,Menticoglou S,Gagnon R,Farine D, Basso M, Bos H. Vaginal delivery of breech presentation. 2009;31557–66.
16.
Hall MH, Carr-Hill R. Impact of sex ratio on onset and management of labour. BMj. 1982;401.
17.
Nelson K, Leviton. How much of neonatal encephalopathy is due to birth asphyxia. arch Pediatr adolesc Med. 1991;1325–31.
18.
Glezerman M. Five years to the term breech trial: the rise and fall of a randomized controlled trial. am j Obstet Gynecol. 2006;20–5.

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