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Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus

BACKGROUND: Breech presentation (BP) results from at random filling of the intrauterine cavity, with an equal probability for a BP or cephalic presentation (CP). Each fetus in BP has its “pair” in CP randomly assumed CP. Direct comparison of BP and CP makes bias to less expressed differences between...

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Autores principales: Sekulic, Slobodan, Stilinovic, Nebojsa, Baturan, Branislava, Krsman, Anita, Tesic, Igor, Vejnovic, Aleksandra, Petrovic, Djordje, Nikolasevic, Zeljka, Mijavec, Anna, Pesic, Vesna, Petkovic, Branka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320854/
https://www.ncbi.nlm.nih.gov/pubmed/37415764
http://dx.doi.org/10.3389/fmed.2023.1160229
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author Sekulic, Slobodan
Stilinovic, Nebojsa
Baturan, Branislava
Krsman, Anita
Tesic, Igor
Vejnovic, Aleksandra
Petrovic, Djordje
Nikolasevic, Zeljka
Mijavec, Anna
Pesic, Vesna
Petkovic, Branka
author_facet Sekulic, Slobodan
Stilinovic, Nebojsa
Baturan, Branislava
Krsman, Anita
Tesic, Igor
Vejnovic, Aleksandra
Petrovic, Djordje
Nikolasevic, Zeljka
Mijavec, Anna
Pesic, Vesna
Petkovic, Branka
author_sort Sekulic, Slobodan
collection PubMed
description BACKGROUND: Breech presentation (BP) results from at random filling of the intrauterine cavity, with an equal probability for a BP or cephalic presentation (CP). Each fetus in BP has its “pair” in CP randomly assumed CP. Direct comparison of BP and CP makes bias to less expressed differences between these two groups. It is therefore necessary to subtract the number of fetuses/newborns from the CP set that are identical to the number of fetuses/newborns in the BP set, with identical characteristics, and add this group to the BP set before comparing them to the rest of the CP fetuses/newborns in the matching process. METHODS: The procedure encompasses nine variables in pregnancies with a congenitally malformed uterus (CMU) identified at the Department of Obstetrics (1985–2014): gestational age, birth mass, birth length, head circumference, shoulders circumference, umbilical length, placental weight, newborn mass/newborn length ratio, and newborn mass/placental mass ratio. Firstly, the probability of BP was determined and its relation to gestational age, physical characteristics, and previous presentations. Then direct comparison as well as case–control matching of the CP and BP were performed. Case–control matching was based on either a single specific variable (M1) or all combined variables (M2). FINDINGS: 462 deliveries were identified with CMU. In 81 cases of multiparity, a fetal presentation was found to be an independent event regardless of the previous presentation, gestational age, and newborn physical characteristics. In four types of CMU with 337 deliveries (Bicornuate, Didelphys, Unicornuate, Arcuate), 9 variables with 36 instances of comparison were observed. M1 in 10 instances and M2 in 6 instances showed a statistically significant lower value of breech/random presentation compared with CP. CP have lower value in 2 instances in M1 and 1 in M2. Statistically significant differences were absent without the matching process. INTERPRETATIONS: The study confirms the maximum probability for the BP is 50%. The case–control matching procedure shows that it is able to detect the difference between the breech/random presentation and CP, while the classic method of direct comparison was unable to detect any differences. The outcome of the breech/random presentation in CMU should be evaluated with the described case–control matching procedure.
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spelling pubmed-103208542023-07-06 Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus Sekulic, Slobodan Stilinovic, Nebojsa Baturan, Branislava Krsman, Anita Tesic, Igor Vejnovic, Aleksandra Petrovic, Djordje Nikolasevic, Zeljka Mijavec, Anna Pesic, Vesna Petkovic, Branka Front Med (Lausanne) Medicine BACKGROUND: Breech presentation (BP) results from at random filling of the intrauterine cavity, with an equal probability for a BP or cephalic presentation (CP). Each fetus in BP has its “pair” in CP randomly assumed CP. Direct comparison of BP and CP makes bias to less expressed differences between these two groups. It is therefore necessary to subtract the number of fetuses/newborns from the CP set that are identical to the number of fetuses/newborns in the BP set, with identical characteristics, and add this group to the BP set before comparing them to the rest of the CP fetuses/newborns in the matching process. METHODS: The procedure encompasses nine variables in pregnancies with a congenitally malformed uterus (CMU) identified at the Department of Obstetrics (1985–2014): gestational age, birth mass, birth length, head circumference, shoulders circumference, umbilical length, placental weight, newborn mass/newborn length ratio, and newborn mass/placental mass ratio. Firstly, the probability of BP was determined and its relation to gestational age, physical characteristics, and previous presentations. Then direct comparison as well as case–control matching of the CP and BP were performed. Case–control matching was based on either a single specific variable (M1) or all combined variables (M2). FINDINGS: 462 deliveries were identified with CMU. In 81 cases of multiparity, a fetal presentation was found to be an independent event regardless of the previous presentation, gestational age, and newborn physical characteristics. In four types of CMU with 337 deliveries (Bicornuate, Didelphys, Unicornuate, Arcuate), 9 variables with 36 instances of comparison were observed. M1 in 10 instances and M2 in 6 instances showed a statistically significant lower value of breech/random presentation compared with CP. CP have lower value in 2 instances in M1 and 1 in M2. Statistically significant differences were absent without the matching process. INTERPRETATIONS: The study confirms the maximum probability for the BP is 50%. The case–control matching procedure shows that it is able to detect the difference between the breech/random presentation and CP, while the classic method of direct comparison was unable to detect any differences. The outcome of the breech/random presentation in CMU should be evaluated with the described case–control matching procedure. Frontiers Media S.A. 2023-06-21 /pmc/articles/PMC10320854/ /pubmed/37415764 http://dx.doi.org/10.3389/fmed.2023.1160229 Text en Copyright © 2023 Sekulic, Stilinovic, Baturan, Krsman, Tesic, Vejnovic, Petrovic, Nikolasevic, Mijavec, Pesic and Petkovic. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Sekulic, Slobodan
Stilinovic, Nebojsa
Baturan, Branislava
Krsman, Anita
Tesic, Igor
Vejnovic, Aleksandra
Petrovic, Djordje
Nikolasevic, Zeljka
Mijavec, Anna
Pesic, Vesna
Petkovic, Branka
Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
title Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
title_full Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
title_fullStr Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
title_full_unstemmed Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
title_short Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
title_sort corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320854/
https://www.ncbi.nlm.nih.gov/pubmed/37415764
http://dx.doi.org/10.3389/fmed.2023.1160229
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