- citations in SCIndeks: 0
- citations in CrossRef:0
- citations in Google Scholar:[
 ]
- visits in previous 30 days:0
- full-text downloads in 30 days:0
|
|
|
2011, vol. 139, iss. 3-4, pp. 155-160
|
|
Breech presentation at term: Caesarean section or vaginal delivery?
Karlična prezentacija ploda u terminu - carski rez ili vaginalni porođaj?
aClinical Centre Kragujevac, Clinic of Gynecology and Obstetrics, Serbia bUniversity of Kragujevac, Faculty of Science, Serbia
email: jnkdjuric@yahoo.com
Abstract
Introduction. Term breech presentation occurs in 3-4% of all deliveries. Most obstetricians are completely sure how to end delivery when the foetus is in breech presentation, by caesarean section as the only option. Objective. The main goal of the paper was to present the method of delivery for term breech presentation analyzed at the Hospital of Gynaecology and Obstetrics and Clinical Centre in Kragujevac, and parameters that influenced the decision on the method of choice to perform delivery with the foetus in breech position. Methods. During a three-year prospective study, the course and outcome of all term breech deliveries were under follow-up. The study involved only deliveries in breech presentation, with a trial of labour ending by vaginal delivery, while elective caesarean section due to breech presentation of the foetus was not included in the study. The following parameters were compared: body mass, newborn's first minute Apgar score and head circumference, gestational maturity, gestational age, delivery duration, maternal level of education and maternal parity. Results. Of total 6,470 deliveries, 653 (10.10%) were finalized by caesarean section. Of these, there were 202 (3.12%) term breech presentations, of which 72 (35.64%) women had caesarean and 130 (64.36%) vaginal delivery. A difference was detected in newborn's body mass and head circumference, delivery duration, maternal level of education and parity between pregnancies terminated surgically in comparison to vaginal delivery, while pregnancy duration, maternal age, first minute Apgar score, and most significantly, perinatal morbidity did not show any difference regardless of the method of delivery for term breech presentation. Conclusion. With respect of all known parameters, vaginal delivery in breech presentation is also accepted.
Sažetak
Uvod. Karlična prezentacija ploda u terminu javlja se kod 3-4% svih porođaja. Većina akušera nema dileme kako završiti porođaj kada je plod postavljen karlično-carskim rezom. Cilj rada. Osnovni cilj rada bio je da se prikaže način kojim se žene porađaju pri karličnoj prezentaciji ploda u Ginekološko-akušerskoj klinici Kliničkog centra u Kragujevcu i koji parametri imaju uticaja na odluku o načinu završetka porođaja ploda s prednjačećom karlicom. Metode rada. Tokom trogodišnjeg prospektivnog istraživanja praćeni su tok i ishod svih terminskih porođaja s karličnom prezentacijom ploda. Ispitivanje je obuhvatilo samo porođaje u karličnoj prezentaciji gde je trudnica uvedena u probni porođaj, dok elektivni carski rezovi, zbog karlične prezentacije ploda, nisu ispitivani. Upoređivani su: telesna masa, Apgar skor u prvom minutu i obim glave novorođenčeta, gestaciona zrelost trudnoće, te starost, trajanje porođaja, stepen obrazovanja i paritet porodilje. Rezultati. Ukupno je bilo 6.470 porođaja, a carskim rezom su završena 653 (10,10%). Od toga, terminskih trudnoća s plodom u karličnoj prezentaciji bilo je 202 (3,12%), pri čemu su carskim rezom završena 72 porođaja (35,64%), dok je vaginalno porođeno 130 trudnica (64,36%). Utvrđena je razlika u telesnoj masi i obimu glave novorođenčeta, paritetu, trajanju porođaja i stepenu obrazovanja majki kod porođaja koji su završeni hirurški u odnosu na porođaje završene vaginalno, dok trajanje trudnoće, starost porodilje, Apgar skor u prvom minutu i, što je najvažnije, perinatalni morbiditet ne pokazuju razlike bez obzira na način završetka porođaja s plodom u karličnoj prezentaciji. Zaključak. Uz poštovanje svih poznatih parametara, prihvatljiv je i vaginalni porođaj kod ploda s prednjačećom karlicom.
|
|
|
|
References
|
|
|
*** (1994) Recommendations of the FIGO Committee on Perinatal Health on guidelines for the management of breech delivery, September 18th, 1993, Rome, Italy, Chairman: Professor Dr W. Kunzel, Giessen, Germany. Int J Gynaecol Obstet, 44(3), str. 297-300
|
|
  
|
Bailit, J.L., Dooley, S.L., Peaceman, A.N. (1999) Risk adjustment for interhospital comparison of primary cesarean rates. Obstetrics and gynecology, 93(6): 1025-30
|
|
3
|
Gilbert, W.M., Hicks, S.M., Boe, N.M., Danielsen, B. (2003) Vaginal versus cesarean delivery for breech presentation in California: A population-based study. Obstetrics and gynecology, 102(5 Pt 1): 911-7
|
|
2
|
Goffinet, F., Carayol, M., Foidart, M.J., Alexander, S., Uzan, S., Subtil, D., i dr. (2006) Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. American Journal of Obstetrics and Gynecology, 194(4): 1002
|
|
3
|
Hannah, M.E., Hannah, W.J., Hewson, S.A., Hodnett, E.D., Saigal, S., Willan, A.R. (2000) Planned caesarean section versus planned vaginal birth for breech presentation at term: A randomised multicentre trial: Term Breech Trial Collaborative Group. Lancet, 356(9239): 1375-83
|
|
|
Hannah, M.E., Hannah, W.J., Hodnett, E.D., Chalmers, B., Kung, R., Willan, A., Amankwah, K., Cheng, M., Helewa, M., Hewson, S., Saigal, S., Whyte, H., Gafni, A. (2002) Outcomes at 3 months after planned cesarean vs planned vaginal delivery for breech presentation at term: The international randomized Term Breech Trial. JAMA, 287(14): 1822-31
|
|
|
Impey, L., Lissoni, D. (1999) Outcome of external cephalic version after 36 weeks' gestation without tocolysis. Journal of maternal-fetal medicine, 8(5): 203-7
|
|
|
Irion, O., Hirsbrunner, A.P., Morabia, A. (1998) Planned vaginal delivery versus elective caesarean section: A study of 705 singleton term breech presentations. British journal of obstetrics and gynaecology, 105(7): 710-7
|
|
1
|
Kayem, G., Goffinet, F., Clement, D., Hessabi, M., Cabrol, D. (2002) Breech presentation at term: Morbidity and mortality according to the type of delivery at Port Royal Maternity hospital from 1993 through 1999. Eur J Obstet Gynecol Reprod Biol, 102(2):137-42
|
|
|
Regalia, A.L., Curiel, P., Natale, N., Galluzzi, A., Spinelli, G., Ghezzi, G.V., Tampieri, A., Terzian, E. (2000) Routine use of external cephalic version in three hospitals. Birth, 27(1): 19-24
|
|
|
Roman, H., Carayol, M., Watier, L., le Ray, C., Breart, G., Goffinet, F. (2008) Planned vaginal delivery of fetuses in breech presentation at term: prenatal determinants predictive of elevated risk of cesarean delivery during labor. European journal of obstetrics, gynecology, and reproductive biology, 138(1): 14-22
|
|
|
st Saunders, N.J. (1996) Controversies: The mature breech should be delivered by elective cesarean section. Journal of Perinatal Medicine, 24:545-51
|
|
|
Su, M., Hannah, W.J., Willan, A., Ross, S., Hannah, M.E. (2004) Planned caesarean section decreases the risk of adverse perinatal outcome due to both labour and delivery complications in the Term Breech Trial. BJOG, 111(10): 1065-74
|
|
|
Tunde-Byass, M.O., Hannah, M.E. (2003) Breech vaginal delivery at or near term. Seminars in perinatology, 27(1): 34-45
|
|
|
Zatuchni, G.I., Andros, G.J. (1967) Prognostic index for vaginal delivery in breech presentation at term: Prospective study. American journal of obstetrics and gynecology, 98(6): 854-7
|
|
|
|
|