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Observational Study
. 2024 Nov;167(2):720-727.
doi: 10.1002/ijgo.15767. Epub 2024 Jul 20.

Routine maneuvers in eutocic breech vaginal delivery at term: A prospective cohort study

Salma Touleimat  1 , Sophia Braund  1 , Pierre Delorme  2 , Alain Diguet  1 , François Goffinet  2   3 , Cécile Hennebert  1   4 , Eric Verspyck  1   5 ; PREMODA study group
Affiliations
Observational Study

Routine maneuvers in eutocic breech vaginal delivery at term: A prospective cohort study

Salma Touleimat et al. Int J Gynaecol Obstet. 2024 Nov.

Abstract

Objective: To study neonatal and maternal outcomes associated with routine maneuvers in breech vaginal delivery at term.

Methods: This was a secondary analysis of the multicenter PREMODA observational prospective study in France and Belgium. We included women with vaginal breech delivery, excluding those who underwent maneuvers to resolve a dystocic delivery. Maternal data and characteristics of labor, in addition to neonatal and maternal outcomes, were recorded. We defined two groups according to mode of delivery; breech vaginal delivery with or without routine maneuvers, and we compared the variables between the groups. To assess the factors associated with adverse perinatal outcomes, a multivariate logistic regression with adjustment for confounders was performed.

Results: Of the 2502 women with planned vaginal deliveries, 1794 were delivered vaginally, 606 of whom were excluded from the study due to maneuvers performed for dystocia. A total of 25 other patients were excluded as a result of missing data. A total of 537 women were included in the routine maneuvers group and 626 women in the no maneuvers group. Adverse perinatal outcome was similar for the two groups (4.5% vs 5.0%, P = 0.65) and no neonatal deaths were reported. Third degree perineal tear and postpartum hemorrhage >1 L rates were comparable for the two groups. After adjustment, the factors associated with adverse perinatal outcomes were primiparity and birth weight <2500 g.

Conclusion: Routine maneuvers were not associated with an increase in neonatal morbidity in our population.

Keywords: breech presentation; breech vaginal delivery; maternal morbidity; neonatal morbidity; routine maneuvers; vaginal breech maneuvers.

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References

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