Cesarean section for breech presentation is often recommended. However, cesarean section affects future reproduction. The aim of this study was to assess the effect of mode of the first birth in breech on outcomes of the second birth and the two births together. This is a register-based nationwide cohort study including 23 062 women with a first singleton birth in breech ≥ 34 gestational weeks and a subsequent singleton birth in Sweden 2000-2019. Exposure was mode of first delivery. Main maternal outcome was a composite of fourth-degree perineal injury, postpartum hemorrhage requiring blood transfusion, hysterectomy, or death. Main infant outcome was a composite of stillbirth, extremely preterm birth (< 28 weeks), moderate to severe hypoxic ischemic encephalopathy, therapeutic hypothermia, or death. Outcomes were analyzed using multivariable logistic regression. In the first birth, the infant composite outcome affected < 1% in both groups but the risk was higher in the vaginal breech group (13/1525), compared with the breech CS group (27/21 537), aOR 7.06, 95% CI 2.91-17.1. In the second birth, the infant composite outcome affected < 1% in both groups but the risk was lower for the first vaginal breech group (3/1525) compared with the first breech CS group (152/21 537), aOR 0.26, 95% CI 0.08-0.84. There was no significant difference between the groups in risk of composite infant outcome in the two births assessed together, or in risk of composite maternal outcome. In total, the chance of a two-children family without maternal or infant severe adverse composite outcome was high and similar regardless mode of the breech first birth.
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http://dx.doi.org/10.1038/s41598-024-76433-7 | DOI Listing |
Eur J Obstet Gynecol Reprod Biol
December 2024
Department of Obstetrics & Gynaecology, Jawaharlal Institute of Medical Education & Research, Puducherry 605006, India. Electronic address:
Objective: To develop and internally validate a model predicting successful trial of labour among pregnant women with previous caesarean scar.
Design: Cohort study.
Setting: Tertiary care and teaching hospital.
Eur J Obstet Gynecol Reprod Biol
December 2024
Obstetrics & Gynaecology, Institution of Clinical Sciences Lund, Lund University, Sweden; Department of Obstetrics and Gynaecology, Skåne University Hospital, Malmö and Lund, Sweden. Electronic address:
Unlabelled: The aim of this systemic review and meta-analysis was to examine the differences in caesarean section rates across European regions and at a country level by utilizing the Robson classification system. The study has compared caesarean rates across European regions using the Robson classification to identify the drivers of caesarean section use. This review shows significant variations in caesarean section rates across European regions, ranging from 16.
View Article and Find Full Text PDFAm J Obstet Gynecol MFM
December 2024
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA. Electronic address:
The goal of standardizing the technique of the routine, uncomplicated cesarean delivery (CD) is to decrease maternal morbidity while optimizing neonatal outcomes. During the procedure, a family-oriented CD is recommended. The low transverse cesarean skin incision (created with either scalpel or diathermy) is preferred with either the Joel-Cohen or Pfannenstiel methods being acceptable.
View Article and Find Full Text PDFPLoS One
December 2024
Breech Without Borders, Crawfordsville, Indiana, United States of America.
Background: Research on community (home or birth center) twin birth is scarce. This study evaluates outcomes of twin pregnancies entering care with a single community practitioner.
Methods: This is a retrospective observational cohort study of 100 consecutive twin pregnancies planning community births during a 12-year period.
Sultan Qaboos Univ Med J
November 2024
Radiology, The Royal Hospital, Muscat, Oman.
Hyperreactio luteinalis (HL) and ovarian hyperstimulation syndrome during pregnancy are both benign conditions where the ovaries are enlarged with presence of multiple thin-walled cysts. The differential diagnosis is ovarian malignancy. Hyperandrogenism with resultant maternal virilisation could be seen in some cases of HL as well as in androgen secreting tumours.
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