Finding the breech: Influence of breech presentation on mode of delivery based on timing of diagnosis, attempt at external cephalic version, and provider success with version

Background Breech presentation affects 3‐4% of pregnancies at term and malpresentation is the primary indication for 10‐15% of cesarean deliveries. External cephalic version is an effective intervention that can decrease the need for cesarean delivery; however, timely identification of breech presen...

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Bibliographic Details
Published in:Birth (Berkeley, Calif.) Calif.), 2017-09, Vol.44 (3), p.222-229
Main Authors: Andrews, Suzanne, Leeman, Lawrence, Yonke, Nicole
Format: Article
Language:English
Subjects:
Adult
Breech position
breech presentation
Breech Presentation - diagnosis
Breech Presentation - therapy
Cesarean section
Cesarean Section - utilization
Chart reviews
Childbirth & labor
Cohort analysis
Cohort Studies
Counseling
Decision trees
Delivery, Obstetric - utilization
external cephalic version
Female
Fetuses
Gestational Age
Humans
Intervention
malpresentation
Medical diagnosis
Medical referrals
Multivariate analysis
Physicians
Pregnancy
Retrospective Studies
Time Factors
Version, Fetal
Women
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Summary:Background Breech presentation affects 3‐4% of pregnancies at term and malpresentation is the primary indication for 10‐15% of cesarean deliveries. External cephalic version is an effective intervention that can decrease the need for cesarean delivery; however, timely identification of breech presentation is required. We hypothesized that women with a fetus in a breech presentation that is diagnosed after 38 weeks’ estimated gestational age have a decreased likelihood of external cephalic version attempted and an increased likelihood of cesarean delivery. Methods This was a retrospective cohort study. A chart review was performed for 251 women with breech presentation at term presenting to our tertiary referral university hospital for external cephalic version, cesarean for breech presentation, or vaginal breech delivery. Results Vaginal delivery was significantly more likely (31.1% vs 12.5%; P
ISSN:0730-7659
1523-536X
DOI:10.1111/birt.12290