Abstract:
BACKGROUND:Research on outcomes of out-of-hospital breech birth is scarce. This study evaluates the outcomes of singleton term breech and cephalic births in a home or birth center setting. METHODS:This is a retrospective observational cohort study of 60 breech and 109 cephalic planned out-of-hospital term singleton births during a 6 year period with a single obstetrician. Outcomes measured included mode of delivery; birth weights; 1 & 5-min Apgar scores; ante-, intra-, and post-partum transports; perineal integrity; and other maternal and neonatal morbidity. RESULTS:50 breech and 102 cephalic presentations were still in the obstetrician's care at the onset of labor; of those, 10 breech and 11 cephalic mothers required transport during labor. 76% of breech and 92.2% of cephalic births were planned to occur at home, with the remainder at a freestanding birth center. When compared to the cephalic group, the breech group had a higher rate of antepartum and in-labor transfer of care and cesarean section. Among completed out-of-hospital births, the breech group had a significantly higher rate of 1-min Apgar scores < 7 but no significant difference at 5 min. Rates of vaginal birth for both groups were high, with 84% of breech and 97.1% of cephalic mothers giving birth vaginally in this series. Compared to primiparas, multiparas in both groups had less perineal trauma and higher rates of out-of-hospital birth, vaginal birth, and spontaneous vaginal birth. No breech infant or mother required postpartum hospital transport, while one cephalic infant and one cephalic mother required postpartum transport. Of the babies born out-of-hospital, there was one short-term and one longer-term birth injury among the breech group and one short-term brachial plexus injury in the cephalic group. CONCLUSIONS:A home or birth center setting leads to high rates of vaginal birth and good maternal outcomes for both breech and cephalic term singleton presentations. Out-of-hospital vaginal breech birth under specific protocol guidelines and with a skilled provider may be a reasonable choice for women wishing to avoid a cesarean section-especially when there is no option of a hospital breech birth. However, this study is underpowered to calculate uncommon adverse neonatal outcomes.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Fischbein SJ,Freeze Rdoi
10.1186/s12884-018-2033-5subject
Has Abstractpub_date
2018-10-11 00:00:00pages
397issue
1issn
1471-2393pii
10.1186/s12884-018-2033-5journal_volume
18pub_type
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2659-y
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
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更新日期:2017-11-13 00:00:00
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
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更新日期:2014-10-03 00:00:00
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2017-11-22 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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journal_title:BMC pregnancy and childbirth
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更新日期:2020-01-08 00:00:00
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journal_title:BMC pregnancy and childbirth
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更新日期:2020-12-10 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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更新日期:2017-02-20 00:00:00
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更新日期:2016-09-21 00:00:00
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/1471-2393-14-245
更新日期:2014-07-23 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0666-1
更新日期:2015-10-05 00:00:00
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/s12884-019-2586-y
更新日期:2019-12-05 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1461-y
更新日期:2017-08-25 00:00:00
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 临床试验,杂志文章
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00
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journal_title:BMC pregnancy and childbirth
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更新日期:2020-12-10 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
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更新日期:2016-06-04 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2020-04-15 00:00:00
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pub_type: 杂志文章
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更新日期:2015-02-03 00:00:00
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更新日期:2015-08-21 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2019-07-19 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2016-09-29 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
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更新日期:2021-01-12 00:00:00