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Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?

2017-06-30Journal article Open access
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dc.contributor.authorFonseca, A
dc.contributor.authorSilva, R
dc.contributor.authorRato, I
dc.contributor.authorNeves, AR
dc.contributor.authorPeixoto, C
dc.contributor.authorFerraz, Z
dc.contributor.authorRamalho, I
dc.contributor.authorCarocha, A
dc.contributor.authorFélix, N
dc.contributor.authorValdoleiros, S
dc.contributor.authorGalvão, A
dc.contributor.authorGonçalves, D
dc.contributor.authorCurado, J
dc.contributor.authorPalma, MJ
dc.contributor.authorLobo Antunes, I
dc.contributor.authorClode, N
dc.contributor.authorGraça, L
dc.date.accessioned2017-09-15T15:09:53Z
dc.date.available2017-09-15T15:09:53Z
dc.date.issued2017-06-30
dc.description.abstractINTRODUCTION: The best route of delivery for the term breech fetus is still controversial. We aim to compare maternal and neonatal outcomes between vaginal and cesarean term breech deliveries. MATERIAL AND METHODS: Multicentric retrospective cohort study of singleton term breech fetuses delivered vaginally or by elective cesarean section from January 2012 - October 2014. Primary outcomes were maternal and neonatal morbidity or mortality. RESULTS: Sixty five breech fetuses delivered vaginally were compared to 1262 delivered by elective cesarean. Nulliparous women were more common in the elective cesarean group (69.3% vs 24.6%; p < 0.0001). Gestational age at birth was significantly lower in the vaginal delivery group (38 ± 1 weeks vs 39 ± 0.8 weeks; p = 0.0029) as was birth weight (2928 ± 48.4 g vs 3168 ± 11.3 g; p < 0.0001). Apgar scores below seven on the first and fifth minutes were more likely in the vaginal delivery group (1st minute: 18.5% vs 5.9%; p = 0.0006; OR 3.6 [1.9 - 7.0]; 5th minute: 3.1% vs 0.2%; p = 0.0133; OR 20.0 [2.8 - 144.4]), as was fetal trauma (3.1% vs 0.3%: p = 0.031; OR 9.9 [1.8-55.6]). Neither group had cases of fetal acidemia. Admission to the Neonatal Intensive Care Unit, maternal postpartum hemorrhage and the incidence of other obstetric complications were similar between groups. DISCUSSION: Although vaginal breech delivery was associated with lower Apgar scores and higher incidence of fetal trauma, overall rates of such events were low. Admission to the neonatal intensive care unit and maternal outcomes were similar. CONCLUSION: Both delivery routes seem equally valid, neither posing high maternal or neonatal complications' incidence.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationActa Med Port. 2017 Jun 30;30(6):479-484pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2750
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCentro Editor e Livreiro da Ordem dos Médicospt_PT
dc.subjectMAC OBSpt_PT
dc.subjectBreech Presentation/therapypt_PT
dc.subjectCesarean Sectionpt_PT
dc.subjectCohort Studiespt_PT
dc.subjectDelivery, Obstetricpt_PT
dc.subjectPregnancy
dc.subjectPregnancy Outcome
dc.subjectRetrospective Studies
dc.titleBreech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?pt_PT
dc.title.alternativeApresentação Pélvica: Parto Vaginal Versus Cesariana, Qual a Melhor Intervenção?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage484pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage479pt_PT
oaire.citation.titleActa Médica Portuguesapt_PT
oaire.citation.volume30pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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