Maternal and neonatal short-term outcome after vaginal breech delivery >36 weeks of gestation with and without MRI-based pelvimetric measurements: a Hannover retrospective cohort study.

IF 1.7 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
Sabine K Maschke, Lena Steinkasserer, Diane Renz, Constantin von Kaisenberg, Peter Hillemanns, Lars Brodowski
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引用次数: 0

Abstract

Objectives: Planning the mode of delivery of a full-term breech singleton remains a challenging task. The aim of this work is to compare the neonatal and maternal short-term outcomes after planned vaginal delivery and caesarean section and to evaluate the influence of an MRI pelvimetry on the short-term outcomes in order to provide appropriate advice to pregnant women with breech presentation.

Methods: This is a retrospective monocentric analysis of all deliveries with singleton pregnancies from breech presentation >36 + 0 weeks of gestation between 08/2021 and 09/2023. Short-term maternal and neonatal morbidity data were collected for intended vaginal deliveries and caesarean sections. Neonatal and maternal short-term outcomes of intended vaginal deliveries with and without MRI pelvimetry were compared.

Results: In the planned vaginal delivery group, APGAR scores and arterial umbilical cord pH were significantly lower than in the planned caesarean group. The rate of asphyxia was similar in both groups. Although not significant, the rate of NICU admission was higher in the vaginal birth group (6.7 % vs. 2.7 %; p=0.27), and infants born by caesarean remained in the NICU longer (1.3 % vs. 1.8 %; p=1.0). Neonates born to women who underwent MRI prior to attempted vaginal delivery had better short-term neonatal outcomes and shorter NICU stays compared with women who did not undergo MRI, after multivariate analysis for fetal birth weight, parity, and gestational age.

Conclusions: Vaginal breech delivery is associated with lower APGAR scores and umbilical arterial pH compared with caesarean section but does not result in increased neonatal asphyxia or NICU admission. Length of stay in the NICU is shorter when a newborn is admitted after vaginal delivery. MRI pelvimetry may improve the outcome of the newborn by further selection.

妊娠36周阴道臀位分娩后产妇和新生儿的短期预后,有和没有基于mri的骨盆测量:汉诺威回顾性队列研究。
目的:计划足月臀位单胎的分娩方式仍然是一项具有挑战性的任务。这项工作的目的是比较计划阴道分娩和剖宫产后新生儿和产妇的短期结果,并评估MRI骨盆测量对短期结果的影响,以便为有臀位的孕妇提供适当的建议。方法:回顾性单中心分析2021年8月至2023年9月期间所有臀位分娩36 + 0周的单胎妊娠。收集预期阴道分娩和剖宫产的短期孕产妇和新生儿发病率数据。新生儿和产妇的短期结果预期阴道分娩有和没有MRI骨盆测量进行比较。结果:阴道计划分娩组APGAR评分及脐带动脉血pH值均明显低于剖宫产组。两组患者的窒息率相似。虽然不显著,但阴道分娩组NICU入院率更高(6.7 % vs. 2.7 %;p=0.27),剖腹产出生的婴儿留在新生儿重症监护病房的时间更长(1.3 % vs 1.8 %;p = 1.0)。在对胎儿出生体重、胎次和胎龄进行多变量分析后,与未接受MRI的妇女相比,在阴道分娩前接受MRI的妇女所生的新生儿短期预后更好,新生儿重症监护病房住院时间更短。结论:与剖宫产相比,阴道臀位分娩与较低的APGAR评分和脐动脉pH有关,但不会导致新生儿窒息或新生儿重症监护病房入住增加。当新生儿在阴道分娩后入院时,在新生儿重症监护病房的停留时间较短。通过进一步的选择,MRI骨盆测量可以改善新生儿的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Perinatal Medicine
Journal of Perinatal Medicine 医学-妇产科学
CiteScore
4.40
自引率
8.30%
发文量
183
审稿时长
4-8 weeks
期刊介绍: The Journal of Perinatal Medicine (JPM) is a truly international forum covering the entire field of perinatal medicine. It is an essential news source for all those obstetricians, neonatologists, perinatologists and allied health professionals who wish to keep abreast of progress in perinatal and related research. Ahead-of-print publishing ensures fastest possible knowledge transfer. The Journal provides statements on themes of topical interest as well as information and different views on controversial topics. It also informs about the academic, organisational and political aims and objectives of the World Association of Perinatal Medicine.
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