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Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study

Background: Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery in...

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Autores principales: Jennewein, Lukas, Brüggmann, Dörthe, Fischer, Kyra, Raimann, Florian J., Pfeifenberger, Hemma Roswitha, Agel, Lena, Zander, Nadja, Eichbaum, Christine, Louwen, Frank
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153626/
https://www.ncbi.nlm.nih.gov/pubmed/34068873
http://dx.doi.org/10.3390/jcm10102117
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author Jennewein, Lukas
Brüggmann, Dörthe
Fischer, Kyra
Raimann, Florian J.
Pfeifenberger, Hemma Roswitha
Agel, Lena
Zander, Nadja
Eichbaum, Christine
Louwen, Frank
author_facet Jennewein, Lukas
Brüggmann, Dörthe
Fischer, Kyra
Raimann, Florian J.
Pfeifenberger, Hemma Roswitha
Agel, Lena
Zander, Nadja
Eichbaum, Christine
Louwen, Frank
author_sort Jennewein, Lukas
collection PubMed
description Background: Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery into obstetricians’ daily practice, we need to gather knowledge from facilities who teach specialized obstetrical management. Methods: We performed a prospective cohort study on 140 vaginal deliveries out of breech presentation solely-managed by seven newly-trained physicians and compared fetal outcome as well as rates of manual assistance in respect to preexisting experience. Results: Fetal morbidity rate measured with a modified PREMODA score was not significantly different in three sub-cohorts sorted by preexisting expertise levels of managing obstetricians (experience groups EG, EG0: 2, 5%; EG1: 3, 7.5%; EG2: 1, 1.7%; p = 0.357). Manual assistance rate was significantly higher in EG1 (low experience level in breech delivery and only in dorsal position) compared to EG0 and EG2 (EG1 28, 70%; EG0: 14, 25%; EG2: 21, 35%; p = 0.0008). Conclusions: Our study shows that vaginal breech delivery with newly-trained obstetricians is a safe option whether or not they have advanced preexisting expertise in breech delivery. These data should encourage implementing vaginal breech delivery in clinical routine.
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spelling pubmed-81536262021-05-27 Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study Jennewein, Lukas Brüggmann, Dörthe Fischer, Kyra Raimann, Florian J. Pfeifenberger, Hemma Roswitha Agel, Lena Zander, Nadja Eichbaum, Christine Louwen, Frank J Clin Med Article Background: Vaginal breech delivery is becoming an extinct art although national guidelines underline its safety and vaginal breech delivery in an upright position has been shown to be a safe birth mode option. In order to spread clinical knowledge and be able to implement vaginal breech delivery into obstetricians’ daily practice, we need to gather knowledge from facilities who teach specialized obstetrical management. Methods: We performed a prospective cohort study on 140 vaginal deliveries out of breech presentation solely-managed by seven newly-trained physicians and compared fetal outcome as well as rates of manual assistance in respect to preexisting experience. Results: Fetal morbidity rate measured with a modified PREMODA score was not significantly different in three sub-cohorts sorted by preexisting expertise levels of managing obstetricians (experience groups EG, EG0: 2, 5%; EG1: 3, 7.5%; EG2: 1, 1.7%; p = 0.357). Manual assistance rate was significantly higher in EG1 (low experience level in breech delivery and only in dorsal position) compared to EG0 and EG2 (EG1 28, 70%; EG0: 14, 25%; EG2: 21, 35%; p = 0.0008). Conclusions: Our study shows that vaginal breech delivery with newly-trained obstetricians is a safe option whether or not they have advanced preexisting expertise in breech delivery. These data should encourage implementing vaginal breech delivery in clinical routine. MDPI 2021-05-14 /pmc/articles/PMC8153626/ /pubmed/34068873 http://dx.doi.org/10.3390/jcm10102117 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jennewein, Lukas
Brüggmann, Dörthe
Fischer, Kyra
Raimann, Florian J.
Pfeifenberger, Hemma Roswitha
Agel, Lena
Zander, Nadja
Eichbaum, Christine
Louwen, Frank
Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
title Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
title_full Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
title_fullStr Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
title_full_unstemmed Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
title_short Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
title_sort learning breech birth in an upright position is influenced by preexisting experience—a frabat prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8153626/
https://www.ncbi.nlm.nih.gov/pubmed/34068873
http://dx.doi.org/10.3390/jcm10102117
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