[Per-partum risk factors of neonatal acidemia in planned vaginal delivery for fetuses in breech presentation].

Abstract

OBJECTIVES:

Delivery mode of term breech presentation is debated because of higher rate of neonatal acidosis (pH<7.15) in planned vaginal delivery than in planned caesarean section. The objective was to evaluate per-partum risk factors of neonatal acidosis in vaginal delivery for podalic fetuses.

METHODS:

It was a single-centre, case-control retrospective study that included planned vaginal delivery in singleton term breech presentation between 2012 and 2016. The "case" group defined by neonatal pH≤7.10 and the "control" group defined by neonatal pH≥7.20 were matched. The maternal, labor, and neonatal characteristics were noted.

RESULTS:

One hundred and thirty-two patients were included: each of 44 patients in "case" group, has been matched according to breech type (legs position) to 2 patients in the "control" group, so 88. In multivariate analysis, significant risk factors identified were oxytocin use [ORa=5.663 (95% CI=1.844-17.397)], "high risk" fetal heart rate (FHR) abnormalities according to FIGO classification [ORa=10.997 (95% CI=1.864-64.866)] and FHR abnormalities during expulsion, Melchior 2 [ORa=8.088 (95% CI=1.192-54.875)] and Melchior 4 [ORa=12.705 (95% CI=1.157-139.541)].

CONCLUSIONS:

These risk factors of neonatal acidemia have to be known to improve the labor management in case of breech planned vaginal delivery.

• Authors: M Vannerum, D Subtil, E Drumez, C Brochot, V Houfflin-Debarge, C Garabedian
• Journal: Gynecologie, obstetrique, fertilite & senologie (Gynecol Obstet Fertil Senol) Vol. 47 Issue 1 Pg. 11-17 (01 2019) ISSN: 2468-7189 [Electronic] France
• Vernacular Title: Facteurs de risque per-partum d’acidose néonatale en cas de tentative d’accouchement voie basse chez les fœtus en présentation podalique.
• PMID: 30563786 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Chemical References

• Oxytocin

Topics

• Acidosis (epidemiology)
• Adult
• Breech Presentation (physiopathology, therapy)
• Case-Control Studies
• Cesarean Section
• Delivery, Obstetric (methods)
• Female
• Heart Rate, Fetal
• Humans
• Hydrogen-Ion Concentration
• Infant, Newborn
• Oxytocin (administration & dosage, adverse effects)
• Pregnancy
• Retrospective Studies
• Risk Factors