oxytocin and Breech-Presentation

Breech presentation at term can cause complications during birth and increase the chance of caesarean section. Moxibustion (a type of Chinese medicine which involves burning a herb close to the skin) at the acupuncture point Bladder 67 (BL67) (Chinese name Zhiyin), located at the tip of the fifth toe, has been proposed as a way of changing breech presentation to cephalic presentation. This is an update of a review first published in 2005 and last published in 2012.. To examine the effectiveness and safety of moxibustion on changing the presentation of an unborn baby in the breech position, the need for external cephalic version (ECV), mode of birth, and perinatal morbidity and mortality.. For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register (which includes trials from CENTRAL, MEDLINE, Embase, CINAHL, and conference proceedings), ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) (4 November 2021). We also searched MEDLINE, CINAHL, AMED, Embase and MIDIRS (inception to 3 November 2021), and the reference lists of retrieved studies.. The inclusion criteria were published and unpublished randomised or quasi-randomised controlled trials comparing moxibustion either alone or in combination with other techniques (e.g. acupuncture or postural techniques) with a control group (no moxibustion) or other methods (e.g. acupuncture, postural techniques) in women with a singleton breech presentation.. We found moderate-certainty evidence that moxibustion plus usual care probably reduces the chance of non-cephalic presentation at birth, but uncertain evidence about the need for ECV. Moderate-certainty evidence from one study shows that moxibustion plus usual care probably reduces the use of oxytocin before or during labour. However, moxibustion plus usual care probably results in little to no difference in the rate of caesarean section, and we are uncertain about its effects on the chance of premature rupture of membranes and cord blood pH less than 7.1.  Adverse events were inadequately reported in most trials.

Topics: Breech Presentation; Cesarean Section; Female; Humans; Infant, Newborn; Moxibustion; Oxytocin; Parturition; Pregnancy; Premature Birth

Although the current literature attests to the merits of a trial of labor in the patient with a prior cesarean section, some controversies remain. For example, can women with two or more sections be allowed a trial of labor and can patients who undergo a trial of labor receive oxytocin or prostaglandins for induction? Also, do certain indications for previous cesarean section such as relative cephalopelvic disproportion/failure to progress or the diagnosis of breech or twins in the present pregnancy constitute an indication for elective repeat cesarean delivery? These questions along with some other controversies are discussed in the light of newly accumulated data in the English literature and our own experience over the last decade in a major university-based tertiary medical center.

Topics: Anesthesia, Epidural; Breech Presentation; Cesarean Section, Repeat; Dinoprostone; Female; Humans; Labor, Induced; Labor, Obstetric; Oxytocin; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Trial of Labor; Twins; Vaginal Birth after Cesarean

Intra-uterine pressure measurement remains the most objective way of measuring uterine activity in labour, and in this respect is superior to clinical assessment or external tocography. However there is little evidence to show that improving the assessment of uterine activity in labour is associated with an improvement in the outcome of labour for mother or fetus. It seems logical that use of intra-uterine pressure monitoring will provide additional safety in women with a scarred uterus, breech presentation, high parity, or apparent failure of response to induction or augmentation of labour with the usual dose rates of oxytocics, but this has not been established by appropriately sized clinical trials. Further research to establish the role of uterine activity measurement in labour is urgently needed.

Topics: Breech Presentation; Cardiotocography; Cesarean Section; Female; Heart Rate, Fetal; Humans; Labor, Obstetric; Oxytocin; Pregnancy; Randomized Controlled Trials as Topic; Transducers, Pressure; Uterine Contraction; Uterus

The cesarean birth rate has continued to climb despite efforts to counteract this trend. A major reason for this rise is the practice of doing an elective repeat cesarean. Our study used a statistical model of meta-analysis to analyze the findings of 29 individual studies that looked at the association between the success of a trial of labor and various preexisting conditions. We hypothesized that various preexisting factors, including cephalopelvic disproportion, previous breech, previous vaginal delivery, more than one previous cesarean, use of oxytocin, and the length of labor and extent of dilatation in the previous cesarean, would affect the prediction of the outcome of a trial of labor. After determining odds ratios for the individual preexisting factors from the individual studies, we calculated overall odds ratios which incorporated the findings from all of the studies. For previous cephalopelvic disproportion, the odds were 0.5 for a successful trial of labor; for prior breech, 2.1; for women with a previous vaginal delivery, 2.1; for women who had had more than one cesarean, 0.7; and for women receiving oxytocin, 0.3. We were unable to analyze other preexisting factors because the data were not available, but short discussions of some of these other factors are offered. Even though the success rates do vary with the different preexisting factors, the clinician may anticipate a greater than 50% chance for success in any individual labor.

Topics: Breech Presentation; Cesarean Section; Female; Humans; Meta-Analysis as Topic; Odds Ratio; Oxytocin; Pelvimetry; Pregnancy; Reoperation; Trial of Labor; Vaginal Birth after Cesarean

Topics: Anencephaly; Breech Presentation; Congenital Abnormalities; Craniotomy; Delivery, Obstetric; Dinoprostone; Female; Fetal Death; Humans; Hydrocephalus; Labor Presentation; Labor, Induced; Oxytocin; Pregnancy; Prostaglandins E

There is limited evidence on the safety and outcome of induction of breech labor. In this study, we aimed to compare the outcomes of spontaneous and induced breech deliveries and to describe variations in induction rates.. This was a retrospective cohort study comprising 1054 singleton live fetuses in breech presentation at Trondheim University Hospital from 2012 to 2019. The main outcome was intrapartum cesarean section, and secondary outcomes were postpartum hemorrhage, anal sphincter ruptures, Apgar scores, pH in the umbilical artery, and metabolic acidosis. All data were obtained from the hospital birth journal.. Induction of labor was performed in 127/606 (21.0%) women with planned vaginal birth. The frequency of intrapartum cesarean section was 48.0% for induced labor vs 45.7% for spontaneous labor (P = .64). We found no differences in the frequency of postpartum hemorrhage or anal sphincter ruptures between induced and spontaneous births. The median pH in the umbilical artery was significantly lower in neonates with induced labor compared with neonates with spontaneous labor (7.22 vs 7.25; P = .02). The frequency of pH <7.05 was 7.0% for induced labor vs 2.9% (P = .05) for spontaneous labor, but the frequency of pH <7.0 was not significantly different: 2.6% vs 0.8% (P = .14), respectively. Three neonates with planned vaginal birth had metabolic acidosis: two with spontaneous labors and one with induced labor. Three fetuses with planned vaginal birth died during labor: two with spontaneous onset of labor and one with induced labor. All three were extremely preterm: two were delivered in week 23 and one in week 25. We did not observe any significant trend in induction rates in either parous or nulliparous women.. The induction rates were stable during the study period. We did not observe any significant difference in intrapartum cesarean section rates, in the frequency of pH <7.0 in the umbilical artery, or in the frequency of metabolic acidosis when comparing induced and spontaneous breech deliveries.

Topics: Adult; Breech Presentation; Cesarean Section; Delivery, Obstetric; Female; Humans; Infant, Newborn; Labor, Induced; Oxytocics; Oxytocin; Pregnancy; Retrospective Studies; Time Factors

The world's understanding of COVID-19 continues to evolve as the scientific community discovers unique presentations of this disease. This case report depicts an unexpected intraoperative coagulopathy during a cesarean section in an otherwise asymptomatic patient who was later found to have COVID-19. This case suggests that there may be a higher risk for intrapartum bleeding in the pregnant, largely asymptomatic COVID-positive patient with more abnormal COVID laboratory values.. The case patient displayed D-Dimer elevations beyond what is typically observed among this hospital's COVID-positive peripartum population and displayed significantly more oozing than expected intraoperatively, despite normal prothrombin time, international normalized ratio, fibrinogen, and platelets.. There is little published evidence on the association between D-Dimer and coagulopathy among the pregnant population infected with SARS-CoV-2. This case report contributes to the growing body of evidence on the effects of COVID-19 in pregnancy. A clinical picture concerning for intraoperative coagulopathy may be associated with SARS-CoV-2 infection during cesarean sections, and abnormal COVID laboratory tests, particularly D-Dimer, may help identify the patients in which this presentation occurs.

Topics: Adult; Antifibrinolytic Agents; Betacoronavirus; Blood Coagulation Disorders; Blood Loss, Surgical; Breech Presentation; C-Reactive Protein; Cautery; Cesarean Section; Coronavirus Infections; COVID-19; Female; Fibrin Fibrinogen Degradation Products; Fibrinogen; Hemostasis, Surgical; Humans; International Normalized Ratio; Methylergonovine; Oligohydramnios; Oxytocics; Oxytocin; Pandemics; Platelet Count; Pneumonia, Viral; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Complications, Infectious; Prothrombin Time; SARS-CoV-2; Tranexamic Acid; Uterine Inertia

Delivery mode of term breech presentation is debated because of higher rate of neonatal acidosis (pH<7.15) in planned vaginal delivery than in planned caesarean section. The objective was to evaluate per-partum risk factors of neonatal acidosis in vaginal delivery for podalic fetuses.. It was a single-centre, case-control retrospective study that included planned vaginal delivery in singleton term breech presentation between 2012 and 2016. The "case" group defined by neonatal pH≤7.10 and the "control" group defined by neonatal pH≥7.20 were matched. The maternal, labor, and neonatal characteristics were noted.. One hundred and thirty-two patients were included: each of 44 patients in "case" group, has been matched according to breech type (legs position) to 2 patients in the "control" group, so 88. In multivariate analysis, significant risk factors identified were oxytocin use [ORa=5.663 (95% CI=1.844-17.397)], "high risk" fetal heart rate (FHR) abnormalities according to FIGO classification [ORa=10.997 (95% CI=1.864-64.866)] and FHR abnormalities during expulsion, Melchior 2 [ORa=8.088 (95% CI=1.192-54.875)] and Melchior 4 [ORa=12.705 (95% CI=1.157-139.541)].. These risk factors of neonatal acidemia have to be known to improve the labor management in case of breech planned vaginal delivery.

Topics: Acidosis; Adult; Breech Presentation; Case-Control Studies; Cesarean Section; Delivery, Obstetric; Female; Heart Rate, Fetal; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Oxytocin; Pregnancy; Retrospective Studies; Risk Factors

The purpose of the study was to examine the risk factors for caesarean section (CS) at full dilatation and to assess the risk and management of haemorrhage. The study took place in a tertiary referral maternity hospital. Women who had a CS at full dilatation were included. Clinical and demographic details were recorded. There were 199 cases. The average age was 30.3 years and average BMI was 25.8kg/m2. There were 79.9 % (159) primigravidas and 20.1% (40) multigravidas. The average gestation at delivery was 39.4 weeks. Labour was induced in 46.9 % (92) and spontaneous in 53.8% (107). Oxytocin was used in 67.8 % (135). An instrumental delivery was attempted in 46.7 % (93). The rate of malposition was 46.5 % (92). The average birthweight was 3,629g and 9 babies weighed ?4.5kg. The average estimated blood loss (EBL) was 665mls and 34 had EBL>1L. Most had an oxytocin infusion (141). Other uterotonic agents were used in 70 women. Seven women had blood transfusions. The highest rate of CS at full dilatation was in primigravidas due to malposition. There was a low rate of major obstetric haemorrhage.

Topics: Adult; Blood Transfusion; Breech Presentation; Cesarean Section; Female; Humans; Infant, Newborn; Labor Stage, First; Oxytocin; Postoperative Hemorrhage; Postpartum Hemorrhage; Pregnancy; Pregnancy Outcome; Risk; Risk Assessment; Risk Factors; Risk Management; Young Adult

To compare the outcome of two methods of labor induction and spontaneous onset of labor in breech presentation at term.. A retrospective study between 2003 and 2012. We compare obstetric (indication of induction, Bishop score, cesarean rate) and perinatal outcomes (Apgar score, umbilical artery pH, base excess ≤-12 mmol/L, admission to neonatal unit) between prostaglandins and oxytocin. We also compare labor induction versus spontaneous onset of labor.. Of the 1684 breech deliveries, we carried out labor induction in 221 cases (76% with prostaglandins, 24% with oxytocin). The prostaglandins group had significantly lower Bishop scores and the time for induction phase was significantly higher. There were no differences in cesarean rate between both methods of induction or spontaneous onset of labor. The prostaglandins group had higher rates of base excess ≤-12 mmol/L. Compared with spontaneous onset of labor in breech presentation, induction had significant lower rates of newborn weight and higher rates of admission to the neonatal unit.. Induction of labor in breech presentation at term is a reasonable and effective option after a careful selection of cases. It was not associated with an increase of perinatal morbidity or cesarean rate compared with spontaneous onset of labor.

Topics: Breech Presentation; Cesarean Section; Cohort Studies; Delivery, Obstetric; Dinoprostone; Female; Humans; Infant, Newborn; Labor Onset; Labor, Induced; Oxytocics; Oxytocin; Pregnancy; Pregnancy Outcome; Retrospective Studies; Spain; Term Birth

To assess factors associated to cesarean section.. A cross-sectional study was conducted in a university hospital in Florianópolis, Southern Brazil, from 2001 to 2005. Socioeconomic, reproductive, obstetric and institutional information were collected. Data from 7,249 deliveries was obtained from medical records and admission, delivery and post-delivery records. Cox regression was used in the analysis to estimate cesarean prevalence ratios in the categories of variables studied.. Cesarean rates increased from 27.5% to 36.5% during the period studied and they were higher than those associated with medical indications. After adjustment for confounders cesarean rates were positively associated with previous cesarean section (PR=2.65, 95% CI: 2.31;3.05), non-cephalic presentation (PR=2.23, 95%CI: 1.69;2.95), oxytocin use (PR=1.77, 95%CI: 1.43;2.19), dilatation at admission (PR=2.74, 95%CI: 2.18;3.44), and obstetrician profile (>35% of cesarean sections) (PR=1.82, 95%CI: 1.36;2.42).. The factors associated with cesarean section indicate the need of interventions focusing on women and their reproductive experience and changes in obstetrician practice as well.

Topics: Adult; Brazil; Breech Presentation; Cesarean Section; Epidemiologic Methods; Female; Gestational Age; Hospitals, University; Humans; Labor Stage, First; Oxytocin; Parity; Practice Patterns, Physicians'; Pregnancy; Socioeconomic Factors

Vaginal breech (VB) delivery at term remains controversial. Our objective was to compare neonatal and maternal outcomes in VB deliveries selected using computed tomographic (CT) pelvimetry to those selected clinically.. A retrospective cohort study of singleton, term, VB deliveries with adequate clinical pelvimetry and estimated fetal weight of 3,850 g was performed. Women in the CT group had adequate pelvimetry by CT measurements. Neonatal and maternal outcomes were recorded.. Of the VB deliveries, 58 women had adequate CT pelvimetry and 37 women were selected using clinical criteria alone. There were no perinatal deaths. Neonatal morbidity was significantly lower in VB deliveries selected using CT criteria at 0% versus 10.8% in the clinically selected group (p=0.02).. VB deliveries selected using CT pelvimetry may be associated with fewer adverse neonatal outcomes than those selected using only clinical criteria. Therefore, it is inappropriate, without CT pelvimetry and strict selection criteria, to conclude that VB deliveries are unsafe. Our experience suggests that there may be a population in which VB delivery is a safe alternative if selected using a combination of specific clinical, sonographic, and CT criteria.

Topics: Adolescent; Adult; Analgesia, Epidural; Breech Presentation; Delivery, Obstetric; Female; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Intensive Care, Neonatal; Labor, Obstetric; Oxytocin; Parity; Pelvimetry; Pregnancy; Pregnancy Outcome; Tomography, X-Ray Computed; Treatment Outcome; Umbilical Arteries

By presentation of cases of spontaneous (nontraumatic) ruptures of previously intact uteri, we sought to emphasize important aspects of this rare and dangerous event.. Two case presentations of oxytocin-associated unscarred uterine rupture and review of pertinent literature are used to study risk factors and accompanying clinical characteristics.. Both spontaneous ruptures of previous unscarred uteri were associated with low-dose oxytocin augmentation, bradycardia, and uterine hyperstimulation monitor patterns and occurred at the onset of the second stage of labor.. Because of its rarity, further investigation of spontaneous uterine rupture will depend on case presentations where the associated events listed are noted and uterine hyperstimulation, fetal bradycardia, and second-stage onset are proved or disproved as valid clinical associations.

Topics: Adult; Blood Transfusion; Bradycardia; Breech Presentation; Female; Fetal Diseases; Heart Rate, Fetal; Humans; Oxytocin; Parity; Pregnancy; Risk Factors; Uterine Hemorrhage; Uterine Rupture; Version, Fetal

To examine the effect of epidural analgesia on the progress and outcome of spontaneous labour in women with a singleton breech presentation at term (greater than or equal to 37 weeks).. A retrospective study.. Data Bank, Aberdeen Maternity Hospital.. 643 women (273 primiparae and 370 multiparae) with a singleton breech presentation and spontaneous onset of labour at term.. Duration of labour; augmentation of labour with oxytocin infusion; caesarean section rates.. Epidural analgesia was associated with a significantly increased need for augmentation of labour with oxytocin infusion (P less than 0.001) and longer duration of labour (P less than 0.001), irrespective of parity. Comparing women who had epidural analgesia with those who did not, there was no significant difference in caesarean section rates in the first stage of labour in primiparae (odds ratio 1.79; 95% CI 0.88-3.63) or multiparae (odds ratio 0.97; 95% CI 0.48-1.96). Epidural analgesia was associated with a significantly increased likelihood of caesarean section in the second stage of labour, both in primiparae (odds ratio 5.43; 95% CI 2.46-11.95) and multiparae (odds ratio 5.37; 95% CI 2.07-13.87). The increased likelihood of caesarean section in the second stage in primiparae with epidurals was independent of the extent of cervical dilatation (less than 3 cm or greater than or equal to 3 cm) on admission. However, in multiparae with epidurals, the difference in second stage caesarean section rate was significant only when initial cervical dilatation was less than 3 cm (odds ratio 3.65; 95% CI 1.14-11.65).. Epidural analgesia was associated with longer duration of labour, increased need for augmentation of labour with oxytocin infusion and a significantly higher caesarean section rate in the second stage of labour.

Topics: Adult; Analgesia, Epidural; Analgesia, Obstetrical; Breech Presentation; Cesarean Section; Female; Humans; Oxytocin; Parity; Pregnancy; Pregnancy Trimester, Third; Retrospective Studies; Trial of Labor

Topics: Breech Presentation; Female; Humans; Infant, Newborn; Kidney; Malpractice; Medical Staff, Hospital; Nursing Staff, Hospital; Obstetric Nursing; Oxytocin; Pregnancy; Resuscitation; South Carolina

In an attempt to reduce the caesarean section rate without an adverse effect on the obstetrical outcome, new guidelines for the management of dystocia, previous caesarean delivery, fetal distress, and breech presentation were introduced in September 1984 in a provincial hospital in Zimbabwe, Africa. Comparison of the two-year periods before and after September 1984 showed that the caesarean section rate had dropped from 16.8 to 8.0%, the maternal mortality rate from 2.0 to 0.5%, and the perinatal mortality rate from 71.9 to 56.2%. During the latter period use of oxytocin increased from 3.4 to 17.4%. These findings suggest that the adoption of strict guidelines can lead to a decrease of the caesarean section rate and an improvement of the obstetrical outcome in the absence of new technology.

Topics: Adult; Breech Presentation; Cesarean Section; Female; Fetal Distress; Humans; Infant Mortality; Infant, Newborn; Maternal Mortality; Oxytocin; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Zimbabwe

Topics: Breech Presentation; Cesarean Section; Delivery, Obstetric; Female; Humans; Labor, Induced; Oxytocin; Poland; Pregnancy; Version, Fetal

Topics: Anesthesia, Local; Breech Presentation; Cesarean Section; Female; Humans; Labor Presentation; Methoxyflurane; Methylergonovine; Oxytocin; Pregnancy; Thiopental

Several authorities have recommended cesarean section for all intrapartum breech presentations. The present study documents that judiciously selected fetuses at term in breech presentation may be safely delivered vaginally by a selective management protocol that requires cesarean section when mandated criteria are not met. The outcome and performance of 6 years of vaginal breech deliveries were evaluated. Those in the control groups were delivered by spontaneous vertex vaginal and elective repeat cesarean section procedures. Morbidity was not different in the protocol breech vaginal delivery group and in the controls. Mortality was found only in the nonprotocol-managed breech vaginal delivery group, which also had a morbidity 5 times greater than that of controls. Approximately half the term breech presentations that are properly selected and managed may be safely delivered vaginally, thereby avoiding a significant number of cesarean sections and subsequent inherent risks.

Topics: Apgar Score; Breech Presentation; Cesarean Section; Delivery, Obstetric; Evaluation Studies as Topic; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor Presentation; New York City; Oxytocin; Patient Care Planning; Pregnancy; Risk

The question whether the termination of a breech pregnancy by a programmed breech delivery would reduce the fetal risk was investigated. In 71 of 433 singleton breech deliveries (16%) the breech delivery was induced by oxytocin infusion. There were 38 primigravidas and 33 multi-gravidas. The Apgar and pH values showed the same results as in 3904 vertex deliveries with spontaneous onset of labour. The duration of labour was shortened. The incidence of Caesarean Section in programmed breech deliveries was 9.86%. All 71 infants were mature and healthy. There were no perinatal deaths. The results show that the fetal risk in breech deliveries is reduced by programmed breech delivery to the same risk as in vertex deliveries with spontaneous onset of labour.

Topics: Apgar Score; Breech Presentation; Female; Humans; Hydrogen-Ion Concentration; Labor Presentation; Labor, Induced; Methods; Oxytocin; Pregnancy

A retrospective study was made of the course and outcome of labour in 226 patients in whom a singleton fetus presented by the breech. Patients with macerated stillbirths or who were delivered before the 28th week of gestation had been excluded. Of the 226 patients, 101 received extradural analgesia, 79 received parenteral analgesia and 46 underwent elective Caesarean section. There was no difference in the incidence of breech extraction or emergency Caesarean section in the first two groups of patients. The length of both first and second stages of labour in multiparae was prolonged in the extradural group, but not markedly so. The Apgar scores of the infants delivered vaginally were not significantly different at one minute in both groups but the five minute Apgar score in the infants of primiparae was significantly higher in the extradural group. The Apgar score at one minute in the group delivered by emergency Caesarean section was significantly lower after extradural block but the difference was not significant at five minutes. This study suggests that the management and outcome of labour when the breech presents is not adversely affected by the provision of extradural analgesia.

Topics: Adult; Anesthesia, Epidural; Anesthesia, Obstetrical; Breech Presentation; Cesarean Section; Female; Humans; Labor Presentation; Labor Stage, First; Labor Stage, Second; Obstetric Labor Complications; Oxytocin; Pregnancy; Time Factors

Between December 1970 and March 1973, 138 patients with a singleton fetus presenting by the breech after 36 weeks of pregnancy were deemed suitable for vaginal delivery under epidural analgesia; 130 were delivered vaginally, 10 of them by breech extraction. There was one stillbirth and no neonatal deaths. Epidural analgesia for vaginal breech delivery seemed beneficial. In 65 cases it was possible to compare the umbilical vein pH with the Apgar score at one minute. In 35 patients a continuous recording of the fetal heart rate was used to predict the Apgar score at one minute and the results are discussed.

Topics: Anesthesia, Epidural; Anesthesia, Obstetrical; Apgar Score; Birth Weight; Blood; Breech Presentation; Female; Fetal Heart; Gestational Age; Heart Rate; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Labor Presentation; Labor, Obstetric; Oxytocin; Pregnancy; Time Factors; Umbilical Cord

This paper presents a study comparing the effects on the mother and baby of a continuous intravenous infusion of pethidine and diazepam and of intramuscular pethidine and promazine. It is concluded that the administration of intravenous pethidine and diazepam is safe in labour provided that diazepam has not been given during the previous week.

Topics: Anesthesia, Obstetrical; Apgar Score; Body Temperature; Breech Presentation; Cesarean Section; Diazepam; Extraction, Obstetrical; Female; Fetus; Humans; Infant, Newborn; Infusions, Parenteral; Injections, Intramuscular; Labor, Induced; Labor, Obstetric; Meperidine; Oxytocin; Pregnancy; Promazine

Topics: Breech Presentation; Cesarean Section; Female; Humans; Injections, Intravenous; Labor Presentation; Labor, Obstetric; Oxytocin; Poland; Pregnancy

Utilizing the Zatuchni-Andros Breech Scoring Index a prospective study of 290 consecutive term breech deliveries occurring at Evanston Hospital from Jan. 1, 1968, to Jan. 1, 1974, is reported. This paper represents a direct continuation of a retrospective study of 500 consecutive term breech deliveries reported by the authorsin 1970. The results indicate that this breech assessment method is a valid method and it is recommended that patients whose breech score is 3 or less be submitted to immediate cesarean section and, conversely, those with a breech score of 4 or more be allowed to labor with meticulous observation with a high confidence level that successful vaginal delivery will result. Also, cautious stimulation with intravenous oxytocin can be safely undertaken when necessary in patients with a breech score of 4 or more. By employment of the Zatuchni-Andros Breech Scoring Index, the authors submit, fetal mortality and morbidity rates are markedly diminished.

Topics: Adolescent; Adult; Apgar Score; Birth Injuries; Birth Weight; Breech Presentation; Cesarean Section; Female; Fetal Death; Humans; Illinois; Infant Mortality; Infant, Newborn; Labor Presentation; Labor, Induced; Methods; Obstetric Labor Complications; Oxytocin; Pregnancy; Prognosis; Prospective Studies; Resuscitation

In our series of vaginal breech deliveries the morbidity from hypoxia and acidosis showed no difference to the same type of morbidity in our series of breech deliveries by Caesarean section. The correct selection of cases, intensive monitoring during labour and the management of the second stage of labour as outlined in our paper are the most important perequisites which permit to plan and justify a vaginal breech delivery in present obstetric practice.

Topics: Acidosis; Birth Injuries; Birth Weight; Breech Presentation; Cephalometry; Cesarean Section; Delivery, Obstetric; Dystocia; Extraction, Obstetrical; Female; Humans; Hypoxia; Infant Mortality; Infant, Newborn; Labor Presentation; Oxytocin; Paralysis, Obstetric; Pelvic Bones; Pelvimetry; Pregnancy; Radiography; Ultrasonography; Umbilical Cord

Topics: Adult; Anesthesia, Epidural; Anesthesia, Obstetrical; Back Pain; Breech Presentation; Bupivacaine; Cesarean Section; Epinephrine; Extraction, Obstetrical; Female; Humans; Labor, Induced; Labor, Obstetric; Muscle Cramp; Obstetrical Forceps; Oxytocin; Pregnancy; Shivering; Surveys and Questionnaires; Urination Disorders

Topics: Birth Injuries; Birth Weight; Breech Presentation; Cesarean Section; Delivery, Obstetric; Diagnosis; Female; Fetal Death; Humans; Infant Mortality; Infant, Newborn; Iowa; Labor Presentation; Obstetric Labor Complications; Oxytocin; Pelvimetry; Pregnancy; Statistics as Topic; Umbilical Cord

Topics: Analgesia; Anesthesia; Anesthesia, Obstetrical; Breech Presentation; Cesarean Section; Delivery, Obstetric; Extraembryonic Membranes; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Labor Presentation; Labor, Induced; Oxytocin; Perinatal Mortality; Placenta Previa; Pregnancy; Umbilical Cord

Topics: Breech Presentation; Cesarean Section; Female; Humans; Infant Mortality; Infant, Newborn; Infant, Premature; Labor Presentation; Oxytocin; Pregnancy; Pregnancy, Multiple

Topics: Breech Presentation; Cesarean Section; Delivery, Obstetric; Drug Therapy; Extraction, Obstetrical; Female; Humans; Infant Mortality; Infant, Newborn; Infant, Premature; Labor Presentation; Oxytocin; Pelvimetry; Pregnancy; Pregnancy, Multiple; Sparteine