- Delivery planning: a contamporary approach to breech presentation in obstetrics
Delivery planning: a contamporary approach to breech presentation in obstetrics
HEALTH OF WOMAN. 2018.3(129):20–23; doi 10.15574/HW.2018.129.20
Kalanzhova O. M. , Galych S. R. , Nіkіtenko R. P.
Odessa national medical University
The world data on stable perinatal losses in breech presentation and a significant increase in the number of cesarean deliveries (70–80%) have led to a search for fundamentally new approaches to breech deliveries.
The objective: the aim of the research is to evaluate the effectiveness and the validity of individual delivery planning for breech presentations.
Materials and methods. Pregnant patients were divided into two groups: 1) the main group (MG) (n=36) which included women with planned conservative deliveries for breech presentations; 2) the control group (CG) (n=33) which included women with planned cesarean deliveries for breech presentations.
Results. Pregnancy completion in the majority of patients from both groups occurred in the planned way: MG – 27 (75%), CG – 29 (87.8%). The MG patients gave birth in the all-fours position – 11 (40.7%) and with the help of the Tsoyanov method – 16 (53.9%). There were 9 (25%) cases of cesarean deliveries in the CG which were mainly classified as the 1st urgency category – 5 (55.5%). The need for urgent cesarean section in the CG occurred in half as many cases – 4 (12.2%) and most cases – 3 (75%) – had the 3rd urgency category. Perinatal complications were more common among the children from the CG who had received manual help at birth: birth trauma – 8 (22.2%), asphyxia – 3 (8.3%), aspiration – 2 (5.55%), hypoxic-ischemic brain damage – 3 (8.3%).
Conclusion. The presented data indicate the lack of highly professional skills which require thorough execution and improvement of obstetrical manipulations by obstetricians and gynecologists.
Key words: breech position, conservative delivery, cesarean section, perinatal outcomes.
1. Tursunova GA, Ahtamova ZM, Nekbaev HS. 2012. Vliyanie novyih tehnologiy na ishodyi rodov i sostoyanie zdorovya novorozhdennyih, rodivshihsya v tazovom predlezhanii. Vestnik neotlozhnoy i vosstanovitelnoy meditsiny 12;1:34–37.
2. Клінічний протокол з акушерської допомоги «Кесарів розтин»: Наказ Міністерства охорони здоров’я України від 27.12.2011 р. № 977. Репродуктивная эндокринология. 2012. 2 (4): 18–33.
3. Burgos J, Rodríguez L, Cobos P et al. 2015. Management of breech presentation at term: a retrospective cohort study of 10 years of experience. Journal of Perinatology 35;10:803–808. https://doi.org/10.1038/jp.2015.75; PMid:26181721
4. Podsvirova EV, Romanova TA, Gurova MM i dr. 2014. Vliyanie techeniya beremennosti i rodov na sostoyanie zdorovya novorozhdennogo rebenka. Nauchnyie vedomosti 24;185:81–84.
5. Davyidova YuV, Chibisova IV, Babich TYu, Padalko LI. 2013. Tazovoe predlezhanie: perinatalnyie aspektyi. Zhіnochіy lіkar 4:27–30.
6. Cammu H, Dony N, Martens G, Colman R. 2014. Common determinants of breech presentation at birth in singletons: a population-based study. European Journal of Obstetrics & Gynecology and Reproductive 177:106–109. https://doi.org/10.1016/j.ejogrb.2014.04.008; PMid:24784711
7. Lyons J, Pressey T, Bartholomew S et al. 2015. Delivery of breech presentation at term gestation in Canada, 2003–2011. Obstetrics & Gynecology 125;5:115–161. https://doi.org/10.1097/AOG.0000000000000794
8. Borbolla FA, Bagust A, Bisits A et al. 2014. Lessons to be learnt in managing the breech presentation at term: an 11-year single-centre retrospective study. Australian and New Zealand Journal of Obstetrics and Gynaecology 54;4:333–339. https://doi.org/10.1111/ajo.12208; PMid:24738867
9. Nikulin LA, Litvinskaya MA, Pomortsev AV. 2008. Vliyanie razlichnyih sposobov rodorazresheniya pri tazovom predlezhanii ploda na techenie perioda ranney adaptatsii novorozhdennyih i v blizhayshem katamneze. Kubanskiy nauchnyiy meditsinskiy vestnik 3/4:120–125.