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BREECH DELIVERY.

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Delivery, Obstetric↗

TRANSVERSE LIE.

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Female↗

[Programmed breech deliveries (author's transl)].

The question whether the termination of a breech pregnancy by a programmed breech delivery would reduce the fetal risk was investigated. In 71 of 433 singleton breech deliveries (16%) the breech delivery was induced by oxytocin infusion. There were 38 primigravidas and 33 multi-gravidas. The Apgar and pH values showed the same results as in 3904 vertex deliveries with spontaneous onset of labour. The duration of labour was shortened. The incidence of Caesarean Section in programmed breech deliveries was 9.86%. All 71 infants were mature and healthy. There were no perinatal deaths. The results show that the fetal risk in breech deliveries is reduced by programmed breech delivery to the same risk as in vertex deliveries with spontaneous onset of labour.

Apgar Score↗

Face presentation: predictors and delivery route.

OBJECTIVE: We sought to identify associated characteristics of face presentation and to examine factors that were associated with mode of delivery in the setting of face presentation. STUDY DESIGN: This was a retrospective cohort study of women who were diagnosed with face presentation during labor. We examined maternal, fetal, and labor characteristics to determine the associations and predictors of cesarean delivery. RESULTS: Fetuses in face presentation were more likely preterm, < 2500 g, and black. An Apgar score of < 7 at 5 minutes was more common in face presentation (10.9%) compared with vertex presentation (4.4%; P = .018). Rates of umbilical artery base excess < -12 or pH < 7.0 were not different. Cesarean delivery was less common in women who received oxytocin (adjusted odds ratio, 0.18; 95% CI, 0.03-0.95) and in women with mentum anterior (14%) as compared with mentum posterior presentation (85%; P < .001). CONCLUSION: This study confirms the association between face presentation and prematurity. The association with black ethnicity may be related to differences in pelvic anatomy. Although face presentation was associated with decreased Apgar scores, no other indicators of fetal asphyxia were identified. Cesarean delivery rates were higher in women with mentum posterior face presentation and in women who did not receive oxytocin.

Apgar Score↗