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

Detalhes bibliográficos
Autor(a) principal: Fonseca, Andreia
Data de Publicação: 2017
Outros Autores: Silva, Rita, Rato, Inês, Neves, Ana Raquel, Peixoto, Carla, Ferraz, Zita, Ramalho, Inês, Carocha, Ana, Félix, Nisa, Valdoleiros, Sandra, Galvão, Ana, Gonçalves, Daniela, Curado, Joana, Palma, Maria João, Antunes, Isabel Lobo, Clode, Nuno, Graça, Luís Mendes
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920
Resumo: Introduction: 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.
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spelling Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?Apresentação Pélvica: Parto Vaginal Versus Cesariana, Qual a Melhor Intervenção?Breech PresentationCesarean SectionDeliveryObstetricApresentação PélvicaCesarianaParto ObstétricoIntroduction: 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.Introdução: A melhor via de parto do feto pélvico de termo ainda é controversa. Pretendemos comparar desfechos maternos e neonatais entre partos vaginais e cesarianas de fetos pélvicos de termo.Material e Métodos: Estudo de coorte, multicêntrico e retrospetivo, incluindo gestações de feto único de termo, em apresentação pélvica, que terminaram em parto vaginal ou cesariana eletiva entre janeiro de 2012 e outubro de 2014. Os desfechos primários foram a morbilidade e mortalidade maternas e neonatais.Resultados: Sessenta e cinco partos vaginais foram comparados com 1262 cesarianas eletivas. As nulíparas foram mais frequentes no grupo das cesarianas (69,3% vs 24,6%; p < 0,0001). A idade gestacional foi inferior nos partos vaginais (38 ± 1 semanas vs 39 ± 0,8 semanas; p = 0,0029), verificando-se o mesmo para o peso ao nascer (2928 ± 48,4 g vs 3168 ± 11,3 g; p < 0,0001). Índices de Apgar < 7 foram mais frequentes nos partos vaginais (1º minuto: 18,5% vs 5,9%; p = 0,0006; OR 3,6 [1,9 - 7,0]; 5º minuto: 3,1% vs 0,2%; p = 0,0133; OR 20,0 [2,8 - 144,4]). Verificou-se também uma maior incidência de traumatismo fetal neste grupo (3,1% vs 0,3%; p = 0,031; OR 9,9 [1,8 - 55,6]). Nenhum grupo teve casos de acidemia fetal. As taxas de internamento na unidade de cuidados intensivos neonatais, de hemorragia materna pós-parto ou de outras complicações obstétricas foram idênticas.Discussão: O parto vaginal associou-se a índices de Apgar inferiores e a uma maior incidência de traumatismo fetal, com taxas globalmente baixas. Não se verificaram diferenças nas taxas de internamento neonatal nem nos desfechos maternos.Conclusão: Ambas as vias de parto parecem adequadas, nenhuma condicionando incidências elevadas de complicações maternas ou neonatais.Ordem dos Médicos2017-06-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/zipapplication/mswordapplication/mswordapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920oai:ojs.www.actamedicaportuguesa.com:article/7920Acta Médica Portuguesa; Vol. 30 No. 6 (2017): June; 479-484Acta Médica Portuguesa; Vol. 30 N.º 6 (2017): Junho; 479-4841646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/5077https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/8557https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/8838https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/8924https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/9391Direitos de Autor (c) 2017 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessFonseca, AndreiaSilva, RitaRato, InêsNeves, Ana RaquelPeixoto, CarlaFerraz, ZitaRamalho, InêsCarocha, AnaFélix, NisaValdoleiros, SandraGalvão, AnaGonçalves, DanielaCurado, JoanaPalma, Maria JoãoAntunes, Isabel LoboClode, NunoGraça, Luís Mendes2022-12-20T11:05:21Zoai:ojs.www.actamedicaportuguesa.com:article/7920Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:31.098235Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
Apresentação Pélvica: Parto Vaginal Versus Cesariana, Qual a Melhor Intervenção?
title Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
spellingShingle Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
Fonseca, Andreia
Breech Presentation
Cesarean Section
Delivery
Obstetric
Apresentação Pélvica
Cesariana
Parto Obstétrico
title_short Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
title_full Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
title_fullStr Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
title_full_unstemmed Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
title_sort Breech Presentation: Vaginal Versus Cesarean Delivery, Which Intervention Leads to the Best Outcomes?
author Fonseca, Andreia
author_facet Fonseca, Andreia
Silva, Rita
Rato, Inês
Neves, Ana Raquel
Peixoto, Carla
Ferraz, Zita
Ramalho, Inês
Carocha, Ana
Félix, Nisa
Valdoleiros, Sandra
Galvão, Ana
Gonçalves, Daniela
Curado, Joana
Palma, Maria João
Antunes, Isabel Lobo
Clode, Nuno
Graça, Luís Mendes
author_role author
author2 Silva, Rita
Rato, Inês
Neves, Ana Raquel
Peixoto, Carla
Ferraz, Zita
Ramalho, Inês
Carocha, Ana
Félix, Nisa
Valdoleiros, Sandra
Galvão, Ana
Gonçalves, Daniela
Curado, Joana
Palma, Maria João
Antunes, Isabel Lobo
Clode, Nuno
Graça, Luís Mendes
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Fonseca, Andreia
Silva, Rita
Rato, Inês
Neves, Ana Raquel
Peixoto, Carla
Ferraz, Zita
Ramalho, Inês
Carocha, Ana
Félix, Nisa
Valdoleiros, Sandra
Galvão, Ana
Gonçalves, Daniela
Curado, Joana
Palma, Maria João
Antunes, Isabel Lobo
Clode, Nuno
Graça, Luís Mendes
dc.subject.por.fl_str_mv Breech Presentation
Cesarean Section
Delivery
Obstetric
Apresentação Pélvica
Cesariana
Parto Obstétrico
topic Breech Presentation
Cesarean Section
Delivery
Obstetric
Apresentação Pélvica
Cesariana
Parto Obstétrico
description Introduction: 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.
publishDate 2017
dc.date.none.fl_str_mv 2017-06-30
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dc.relation.none.fl_str_mv https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/5077
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/8557
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/8838
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/8924
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/7920/9391
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2017 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2017 Acta Médica Portuguesa
eu_rights_str_mv openAccess
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application/zip
application/msword
application/msword
application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 30 No. 6 (2017): June; 479-484
Acta Médica Portuguesa; Vol. 30 N.º 6 (2017): Junho; 479-484
1646-0758
0870-399X
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