Breech at term--mode of delivery? A register-based study
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Breech at term--mode of delivery? A register-based study. / Krebs, L; Langhoff-Roos, J; Weber, T.
In: Acta Obstetrica et Gynecologica, Vol. 74, No. 9, 10.1995, p. 702-6.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Breech at term--mode of delivery?
T2 - A register-based study
AU - Krebs, L
AU - Langhoff-Roos, J
AU - Weber, T
PY - 1995/10
Y1 - 1995/10
N2 - BACKGROUND: The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other.METHODS: Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death.RESULTS: A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores.CONCLUSIONS: Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by cesarean section.
AB - BACKGROUND: The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other.METHODS: Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death.RESULTS: A total of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores.CONCLUSIONS: Register data on singleton term breech deliveries imply that vaginal delivery is associated with increased mortality and morbidity. However, validation of data and additional information from the medical records are needed before a recommendation of whether selection of parturients, structure of perinatal care or professional skills need to be improved, or all singleton term infants in breech presentation should be delivered by cesarean section.
KW - Apgar Score
KW - Birth Weight
KW - Breech Presentation
KW - Cesarean Section
KW - Decision Making
KW - Delivery, Obstetric
KW - Denmark
KW - Female
KW - Humans
KW - Infant Mortality
KW - Infant, Newborn
KW - Male
KW - Parity
KW - Pregnancy
KW - Pregnancy Outcome
KW - Registries
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
M3 - Journal article
C2 - 7572104
VL - 74
SP - 702
EP - 706
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 9
ER -
ID: 179629274