Breech presentation: Does the decision of vaginal delivery depend on parity?

##plugins.themes.academic_pro.article.sidebar##

Published Oct 27, 2015
Download
pdf
Vol. 93 No. 6 (2015): Issue Jun 2015

##plugins.themes.academic_pro.article.main##

Fathia Boudaya
Najeh Hecini
Amel Achour
Dalenda Chelli

Abstract

Background: Background: The breech presentation delivery mode is still controversial. The cesarean section is becoming the current trend especially in case of primiparous.
Aim : To compare the maternal and fetal prognosis of the breech presentation delivery according to the parity.
Methods: We conducted a retrospective comparative study covering a two years period. Our data was collected from all patients accepted for vaginal delivery of breech presentation into the entree of the labor room. We compared the primiparous group (G1, n=45) to a second group with parity ≥ 2 (G2, n=56) in terms of maternal and fetal prognosis.
Results: The two groups were comparable in term of epidemiological profile and labor evolution. The average age was of 28,2 years in the group G1 vs 30,9 years in the group G2. The average term was 37,4 weeks of amenorrhea, comparable between both groups. We did not note statistically significant difference between both groups regarding duration of work shifts. Indeed, the phase of latency had lasted 4,2 hours in the group G1 vs 3,8 hours in the group G2. The active phase had lasted 3,4 hours in the group G1 vs 2,3 hours in the group G2. 71% of the deliveries of the group primipare and 78 % of multipare had taken place in Vermelin. The appeal to a caesarian during the work was necessary to 5 (11,1 %) primipares against 3 (5,3 %) in the group G2. This difference was not significant (p=0,5). We objectified no statistically significant difference in term of foetal prognosis (Apgar 7 in 1 minute: G1 (n=2) vs G2 (n=2) with p=0.82 or of transfer in
neonatal resuscitation: G1 (n=5) vs G2 (n 3) with p= 0.28 between both groups.
Conclusion: We can conclude that the parity is not a significant variable in the vaginal delivery of the breech presentation.

Keywords:

Breech presentation, vaginal delivery, parity

##plugins.themes.academic_pro.article.details##

References

  1. ACOG Committee on Obstetric Practice. ACOG Committee Opinion No. 340. Mode of term singleton breech delivery. Obstet Gynecol 2006 ;108: 235-7.
  2. Merger R. Lévy J. Melchior J. Précis d'Obstétrique. 6th ed. Paris : Masson, 1995.
  3. Lansac g body G. Pratique de l'accouchement. 2th ed. Paris: SIMEP, 1992.
  4. Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal S, Willan AR. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomized multicentre trial. Term Breech Trial Collaborative Group. Lancet 2000; 356:1375-83.
  5. Hogle K, Kilburn L, Hewson S, Gafni A, Wall R, Hannah M. Impact of the international term breech trial on clinical practice and concerns: a survey of centre collaborators. J Obstet Gynaecol Can 2003; 25:14-6.
  6. Michel S, Drain A, Closset E, Deruelle P, Subtil D. Évaluation des protocoles de décision de voie d'accouchement en cas de présentation du siège dans 19 CHU en France. J Gynecol Obstet Biol Reprod 2009 ; 38:411-20.
  7. Goffinet F, Carayol M, Foidart JM et al. Is planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium. Am J Gynecol Obstet Biol Reprod 2001; 30: 187-90.
  8. Azria E, Schmitz T, Bourgeois-Moine A, Goffinet F, Tsatsaris V, Mahieu- Caputo D. Peut-on concilier autonomie maternelle et responsabilité médicale dans les décisions de voies d'accouchement des foetus en siège ? Rôle de l'information. Gynecol Obstet Fertil 2009; 37: 464-9.
  9. Gimovsky ML. Singleton Vaginal Breech Delivery at Term: Still a Safe Option. Obstet Gynecol 2004;103: 407-12.
  10. Goffinet F, Carayol M, Foidart JM, et al. 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 ;194 :1002-11.
  11. Carbonne B. Hannah's term breech trial: for whom the bell tolls? Gynecol Obstet Fertil 2006; 34:677-8.
  12. Haheim LL, Albrechtsen S, Berge LN, et al. Breech birth at term: vaginal delivery or elective cesarean section? A systematic review of the literature by a Norwegian review team. Acta Obstet Gynecol Scand 2004; 83:126-30.
  13. Delotte J, Trastour C, Bafghi A, Boucoiran I, D'Angelo L, Bongain A. Influence de la voie d'accouchement dans la présentation du siège à terme sur le score d'Apgar et les transferts en néonatologie. Résultats de la prise en charge de 568 grossesses singleton dans une maternité française Niveau III. J Gynecol Obstet Biol Reprod 2008 ; 37:149-53.
  14. Whyte H, Hannah M, Saigal S, et al. Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial. Am J Obstet Gynecol 2004; 191:864-71.
  15. Carbonne B, Frydman R, Goffinet F, Pierre F, Subtil D, CNGOF. Recommandations pour la pratique clinique. Césarienne: conséquences et indications. J Gynecol Obstet Biol Reprod 2000; 29:9-108.
  16. Martel MJ, MacKinnon CJ; Clinical Practice Obstetrics Committee, Society of Obstetricians and Gynaecologists of Canada. Guidelines for vaginal birth after previous caesarean birth. J Obstet Gynaecol Can 2005; 27:164-88.
  17. Lagrange E, Ab der Halden M, Ughetto S, et al. Breech presentation and vaginal delivery: evolution of acceptability by obstetricians and patients. Gynecol Obstet Fertil 2007; 35:757-63.
  18. Carcopino X, Shojai R, D'Ercole C, Boubli L. French trainees in obstetrics and gynaecology theoretical training and practice of vaginal breech delivery: a national survey. Eur J Obstet Gynecol Reprod Biol 2007; 135:17-20.
  19. Samouëlian V, Subtil D. Accouchement par le siège en 2008 : le choix de la voie basse s'impose. Gynecol Obstet Fertil 2008 Jan;36:3-5.
  20. Morrison JJ, Rennie JM, Milton PJ. Neonatal respiratory morbidity and mode of delivery at term: influence of timing of elective caesarean section. Br J Obstet Gynaecol 1995; 102: 101-6.
  21. Doyle NM, Riggs JW, Ramin SM et al. Outcome of term vaginal breech delivery. Am J perinatal2005;22:325-8.
  22. Golfier F, Vaudoyer F, Ecochard R, Champion F, Audra P, Raudrant D. Planned vaginal delivery versus elective caesarean section in singleton term breech presentation: a study of 1116 cases. Eur J Obstet Gynecol Reprod Biol. 2001; 8:186-92.
  23. Hannah ME, Hannah WJ, Hodnett ED et al. Outcomes at 3 Months After Planned Cesarean vs Planned Vaginal Delivery for Breech Presentation at Term The International Randomized Term Breech Trial. JAMA 2002;287:1822-31.