Maternal and neonatal outcome after vaginal breech delivery of nulliparous versus multiparous women of singletons at term—A prospective evaluation of the Frankfurt breech at term cohort (FRABAT). (September 2020)

• Record Type: Journal Article
• Authors: Kielland-Kaisen, Ulrikke; Paul, Bettina; Jennewein, Lukas; Klemt, Anna; Möllmann, Charlotte J.; Bock, Nina; Schaarschmidt, Wiebke; Brüggmann, Dörthe; Louwen, Frank
• Is Part Of: European journal of obstetrics, gynecology, and reproductive biology. Volume 252(2020)
• Page Start: 583
• Page End: 587
• Publication Date: 2020-09
• Subjects: Vaginal delivery -- Breech -- Delivery mode -- Nulliparous; Obstetrics -- Periodicals; Gynecology -- Periodicals; Reproductive health -- Periodicals; Gynecology -- Periodicals; Obstetrics -- Periodicals; Reproduction -- Periodicals; Obstétrique -- Périodiques; Gynécologie -- Périodiques; Reproduction -- Périodiques; Verloskunde; Gynaecologie; Voortplanting (biologie); Gynecology; Obstetrics; Reproduction; Electronic journals; Periodicals; Electronic journals; 618.05
• DOI: 10.1016/j.ejogrb.2020.04.029
• Languages: English
• ISSNs: 0301-2115

Abstract

Abstract: Introduction: The best way to deliver a term breech infant is still a much discussed topic among obstetricians. The question whether nulliparity should be considered an exclusion criterion for an intended vaginal breech delivery is not fully answered. Objective: We compared maternal and neonatal outcome of intended vaginal breech deliveries of nulliparous versus multiparous women at term. Study design: We conducted a prospective case-control study between January 2004 and December 2016. 1046 women expecting singletons at term with favorable pelvic measurements were enrolled in the study. Results: Neonatal morbidity and mortality was not significantly different in deliveries of nulliparous (n = 647) versus multiparous (n = 399) women. Nulliparous women had a significantly higher rate of a cesarean section during labor than multiparous women. Maternal birth-injury rates and the use of epidural anesthesia were significantly higher comparing vaginal births of nulliparous (n = 384) versus multiparous (n = 331) women. Conclusion: Nulliparity seems not be an exclusion criterion for intended vaginal breech birth at term. It is still important to inform the women of an increased risk of a cesarean section during labor. A clinical management built on this evidence might reduce negative implications for future pregnancies.