scholarly journals Zunanji obrat ploda na glavico v Porodnišnici Izola

2017 ◽  
Vol 86 ◽  
Author(s):  
Boštjan Lovšin ◽  
Mladen Mrkajić ◽  
Janja Zver-Skomina ◽  
Dušan Deisinger
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Breech Presentation ◽  
Muscle Relaxants ◽  
External Cephalic Version ◽  
Uterine Muscle ◽  
Obstetrics And Gynaecology ◽  
Almost All ◽  
Professional Guidelines ◽  
Fetal Position

Background: Almost all babies in breech presentation at term are delivered by caesarean section. Professional guidelines recommend an attempt of external cephalic version to reduce breech presentations at birth and thus the proportion of caesareans. Our aim was to analyse the clinical and ultrasound factors to predict the outcome of version and check the hypothesis, if the implementation of the external cephalic version helps to reduce the number of caesareans.Methods: The study included all attempts of external cephalic version after 36 weeks of pregnancy at the Department of Obstetrics and Gynaecology in Izola General Hospital from 2002 to 2010.Results: 68/143 (47.6 %) external cephalic versions were successful. the success of intervention was mostly influenced by a greater amount of amniotic fluid, higher fetal position in the pelvis and transverse or oblique lie of the fetus. With 100 attempts of external cephalic version 32 caesareans were avoided or one cesarean per 3.1 attempts.Conclusions: the study has confirmed that by performing external cephalic version the number of caesareans can be reduced. The proportion of successful versions was comparable to studies in the literature despite the minimal use of uterine muscle relaxants.

Breech Presentation: Vaginal Delivery or Caesarean Section?

2016 ◽  
Vol 2 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Total Population ◽  
Population Sample ◽  
Breech Presentation ◽  
Current Paper ◽  
Clinical Hospital ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

Women's perception of choice and support in making decisions regarding management of breech presentation

2021 ◽  
Vol 29 (7) ◽  
pp. 392-400
Author(s):  
Antonio Sierra
Keyword(s):  
Breech Presentation ◽  
Study Data ◽  
External Cephalic Version ◽  
Structured Interviews ◽  
Management Options ◽  
Lower Segment Caesarean Section ◽  
Postnatal Women ◽  
Phenomenological Research Design ◽  
Colaizzi's Method ◽  
Professional Guidelines

Background Professional guidelines recommend midwives and obstetricians actively involve women in making decisions about their care. To date, breech research has focused mainly on assessing the effectiveness of different management options. Aim This research explores women's experience of breech presentation and their perception of choice and support in making decisions with regards to breech management. Methods This study uses a phenomenological research design. Semi-structured interviews took place in hospital or women's homes. A total of six postnatal women who were diagnosed with breech presentation after 36 weeks' gestation took part in the study. Data was analysed using Colaizzi's method. Findings A total of 84 significant statements were clustered into four main emerging themes. These include women's feelings, their healthcare expectations, their preferences and their values. Results Breech discussions mostly occurred between obstetricians and women. These primarily focused on external cephalic version, Elective Lower Segment Caesarean Section and Breech Vaginal Birth. These options did not always become choices available to women.

External Cephalic Version at Term with Tocolysis

1988 ◽  
Vol 18 (3) ◽  
pp. 119-124 ◽  
Author(s):  
G Justus Hofmeyr
Keyword(s):  
Developing Countries ◽  
Caesarean Section ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Cephalopelvic Disproportion ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
High Prevalence ◽  
Large Families ◽  
Tocolytic Agents

The problems associated with breech presentation are of particular importance in developing countries. The risk of vaginal breech delivery may be increased because of a high prevalence of cephalopelvic disproportion. Caesarean section presents specific risks to women who may not have medical care in subsequent pregnancies and may desire large families. External cephalic version (ECV) before term has not been proved conclusively to influence the outcome of pregnancy. ECV performed at term (37 or more weeks gestation), using tocolytic agents to relax the uterus, has been shown in a technologically developed setting to reduce the incidence of breech presentation and of Caesarean section. The application of this procedure when technological facilities are limited is discussed and the technique is described.

scholarly journals External cephalic version at 36 weeks and its outcome

2017 ◽  
Vol 6 (10) ◽  
pp. 4602
Author(s):  
Deepika N. ◽  
Arun Kumar
Keyword(s):  
Caesarean Section ◽  
Success Rate ◽  
Caesarean Section Rate ◽  
Invasive Procedure ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Clinical Settings ◽  
Safe Procedure ◽  
Breech Delivery ◽  
Non Invasive

Background: External cephalic version (ECV) is well known non-invasive procedure done for the management of breech presentation but is not routinely practised by obstetricians in many clinical settings. The aim of the study was to assess the success rate of external cephalic version, labour outcome of pregnancy after successful ECV, to study maternal and foetal complications associated with ECV and to explore the reasons for failed ECV.Methods: It was a prospective interventional study to assess the labour outcomes of pregnancies with successful and uncomplicated ECV. All women who had singleton breech presentation at 36+ weeks were included unless contraindications for ECV were present. After obtaining consent, ECV was attempted after giving tocolysis.Results: The total number of deliveries was 6038 in the same period. Out of these 301 were breech presentations thus the incidence of breech presentation was 4.9%. ECV was offered to 81 women (26.9%) and out of these 77 women (95.06%) gave consent for the procedure. The remaining 4 (4.93%) did not give consent due to anxiety about the procedure. The success rate was 54.54%. Out of total 301 women with breech presentation 40 women (13.3%) had assisted breech delivery and 216 women (71.8%) had caesarean section due to obstetric indications. Thus the caesarean section rate for breech presentation at our institute was 71.8%. ECV was successful in 63.82% of the multigravida on which it was attempted as compared to 40% of the primigravida. The success rate of ECV in the present study is maximum when ECV was performed at a gestational age of 38-39 weeks and when fetal weight was less than 3000 grams. Out of the 42 successful ECV cases, 4 babies (9.52%) had neonatal sepsis and 1 was still born (2.3%) which was unrelated to ECV.Conclusions: ECV is a valuable though under used option in the management of breech presentation at term. It is a relatively safe procedure, simple to learn and perform. Vigilance for breech presentation after 36 weeks is important. ECV at term using tocolytics should be part of the routine management of breech presentation.

Breech Presentation: Vaginal Delivery or Caesarean Section?

2016 ◽  
Vol 4 (1) ◽  
pp. 153
Author(s):  
Tomescu Cezar Laurentiu ◽  
Rodica Sîrbu ◽  
Emin Cadar ◽  
Brezeanu Dragos ◽  
Aneta Tomescu
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Vaginal Delivery ◽  
Total Population ◽  
Population Sample ◽  
Breech Presentation ◽  
Current Paper ◽  
Clinical Hospital ◽  
Obstetrics And Gynaecology ◽  
Number Of Patients

The incidence of breech presentation is approximately 3,97%. Breech presentation is considered as being “borderline eutocic” and it requires carefully monitoring both the foetus and the mother. The aim of the current paper is to evaluate the preffered method of delivery in case of breech presentation. The paper presents a retrospective study performed in the Obstetrics and Gynaecology Departments of the County Emergency Clinical Hospital “Sf. Apostol Andrei” in Constanta, during a period of 5 years (2010-2014). The methods of birth were analyzed for a lot of 1104 patients with breech presentation with ages ranging between 16 and 44 years old. The total number of patients who gave birth through vaginal delivery was of 139 patients, amounting to 12.59% of the total population sample. The number of patients that gave birth through C-section was 965, which amounts to 87.4% of the total population sample. Birth through C-section is preferred by both obstetricians and patients alike, due to the fact that vaginal delivery is associated with a higher foetal risk in breech presentation.

Experiences with High Success Rate of External Cephalic Version and Comparisons of Different Tocolysis for Risk-effective version based on a bayesian network meta-analysis

2020 ◽  
Author(s):  
Xiao Yunyun ◽  
Ma Si Yu ◽  
Li Jing ◽  
Zhao Wei ◽  
Dong Yan
Keyword(s):  
Amniotic Fluid ◽  
Bayesian Network ◽  
Success Rate ◽  
Meta Analysis ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
High Success Rate ◽  
Cochrane Library ◽  
Tocolytic Agents ◽  
Selection Of

Abstract Background: External cephalic version (ECV) has been proved effectively in reducing the cesarean section rates, but the success rates of the procedure are uneven. Experiences of ECV with high success rate were concluded in this paper. And in order to evaluate the efficiency of the applied tocolytic agents, a corresponding bayesian-network meta-analysis was conducted.Methods: Through retrospective analysis of eighty-four single pregnant women with breech presentation near or at term who received ECV from Dalian Maternal and Child Health Care Hospital from April 2017 to November 2019, influence factors associated with the success rate of ECV were analyzed. Meanwhile, a bayesian-network meta-analysis including sixteen eligible randomized controlled trials (RCTs) about comparisons of five common tololytic agents and placebo with 3468 participants searched from Pubmed, Cochrane library and Embase databases until May 20, 2019 was conducted to identify the efficiency of ritodrine and terbutaline applied in the authors’ procedures. Results: The ECV procedures were conducted by a skilled obstetrician through strict selection of the candidates. Oral ritodrine, intravenous terbutaline in combination with epidual analgesia were applied as interventions. Success rate of ECV reached 90.48% (76/84) and the overall vaginal delivery rate is up to 88.16% (67/76). Only one patient reverted to breech presentation due to loose of the bellyband. Among the possible variables, amniotic fluid index were identified to have significantly relationship with the success rate of ECV. As the bayesian network meta-analysis proved: terbutaline, salbutamol and ritodrine played more important roles than nitroglycerine and nifedipine on the success rate of ECV. But salbutamol was found to have more common side effects than terbutaline and ritodrine.Conclusions: We conclude that factors influencing the success rate of ECV mainly include: 1. characteristics of the mothers and fetuses, 2. interventions, 3. skills of the surgeon. During ECV process, selection of patients with enough amniotic fluid and proper stature with no contraindications is essential. And a more detailed scoring standard according to the possible influence indicators of the mothers and fetuses for the feasibility of ECV should be set up in the future. Besides, application of terbutaline and ritodrine as tocolytic agents during ECV procedure were considered to be effective for increasing successful versions.

Variations in the Management of Singleton Breech Presentation Throughout Scotland

1998 ◽  
Vol 43 (5) ◽  
pp. 144-145 ◽  
Author(s):  
S. Z. S. Yahya ◽  
J. Williams ◽  
A. Mathers ◽  
S. Bjornsson ◽  
A. D. Cameron ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Breech Presentation ◽  
Postal Questionnaire ◽  
External Cephalic Version ◽  
Breech Delivery ◽  
Vaginal Breech Delivery ◽  
Post Procedure ◽  
Line Management

Breech presentation occurs in 3–5% of deliveries and can be managed by either a trial of vaginal breech delivery (TOVBD), external cephalic version (ECV) or Caesarean section.1 A postal questionnaire was completed by 82% of Scottish consultant obstetricians and revealed wide variations in practice. Eighteen percent never offered ECV. Among those who did consensus was lacking on some contraindications. One-quarter sometimes performed ECV before 37 weeks gestation despite the possibility ofspontaneous version. Only 70% restricted ECV to one or more designated operators thereby maintaining levels of expertise. Variations were demonstrated in the use of tocolytics, and pre and post procedure investigations. Following failed ECV 28% considered a repeat attempt and 56% a TOVBD. TOVBD was not offered asjirst line management by one-fifth of respondents. Those who did varied in the pre-procedure investigations performed. Guidelines are required to ensure safe, consistent practice and avoid unnecessary Caesarean sections.

scholarly journals Faktor-faktor yang Mendukung dan Menghambat Dilakukannya Versi Luar pada Kehamilan dengan Presentasi Bokong di Yogyakarta

2020 ◽  
Vol 7 (2) ◽  
pp. 88
Author(s):  
I Made Pariartha ◽  
Rukmono Siswishanto ◽  
Nuring Pangastuti
Keyword(s):  
Mixed Methods ◽  
Important Determinant ◽  
Breech Presentation ◽  
External Cephalic Version ◽  
Qualitative Model ◽  
Mixed Methods Design ◽  
Validated Questionnaire ◽  
Depth Interview ◽  
Explanatory Mixed Methods ◽  
Almost All

Background: Guidelines recommend that external cephalic version (ECV) should be offer to all women with fetus in breech presentation at term. Many literature show external cephalic version can lowering c-section rate caused by breech presentation.Objective: To explore the determinants (barriers and facilitators) affecting obstetricians and gynaecologists to do external cephalic version at Yogyakarta.Method: Explanatory mixed methods design with quantitative-qualitative model. Survey with validated questionnaire and in-depth interview with semi-structured question was done January 2019 until August 2019.Results and Discussion: 72 respondents (83.7%) was responded to questionnaire and in-depth interview was done to 12 respondents. Adherence to ECV guideline was varied: counselling (20.8%), advising for ECV (15.3%), and arranged for ECV to for (almost) all their clients (16.6%). Although 76.4% of respondents considered ECV to be an effective treatment for preventing caesarean childbirth, only 18.1% respondents agreed that every client with breech presentation should undergo ECV. Self-efficacy was the most important determinant influencing adherence. In-depth interview shows several determinants to performed or did not performed ECV: skill of clinicians, guideline for ECV, facility to emergency c-section, ECV characteristic, cost, other methods for breech presentation, perception about ECV in lowering c-section rate, perceived ECV risk and patient preferences.Conclusion: Most respondents agreed that ECV was effective intervention to reduce caesarean childbirth, but adherence to counselling, advising and arranging ECV for clients still very low. Several determinants influenced obstetrician and gynaecologists to perform or did not perform ECV.Keywords: External cephalic version; breech presentation; determinants.

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