Neonatal outcomes in twin pregnancies with the first twin in breech presentation according to the mode of delivery: A cohort study from Dakar Senegal

The objectives of this study were to compare perinatal outcomes in twin pregnancies where the first twin was in the breech presentation. To do so, we performed a 10-year retrospective cohort study in a single university center. All patients with a twin pregnancy with the first twin in breech presentation, a gestational age greater than or equal to 34 weeks' gestation, and a birth weight >= 1500 g were included. The main outcome measures were 5-minute Apgar score <7 and perinatal mortality. We included 353 pairs of twins which complied with the inclusion criteria. One hundred and fifty (150) patients delivered vaginally while 203 pairs of twins were delivered by caesarean section. Patients who delivered abdominally were similar to those who delivered vaginally with regard to age, parity, and gestational age. Six twins A delivered vaginally and 2 delivered by caesarean section had an Apgar score < 7 (p = 0.76) whereas 12 twins B delivered vaginally and 2 delivered abdominally had an Apgar score <7 (p = 0.001). Perinatal mortality did not differ significantly between twins delivered abdominally and those delivered vaginally. There was no evidence that vaginal delivery was risky with regards to depressed Apgar scores for Twin A and neonatal mortality for breech first twins that weighed at least 1500 g. However, Twin B delivered vaginally were more likely to present with a low 5-minute Apgar score. Along with the literature, the findings of this study do not currently allow to define a consensual obstetric attitude towards management of breech first twin deliveries. Until more prospective multicenter randomized controlled studies shed light on this problem, the skills, experience and judgment of the obstetrician will play a major role in the decision-making process. (Afr J Reprod Health 2022; 26[5]: 50-56).

Breech presentation at term: outcomes and mode of delivery in a tertiary care teaching hospital In South India

The aim of this study was to study the outcomes of all patients who presented with breech presentation at term (≥37 weeks), to assess what percentage of patients were offered External cephalic version (ECV), the rates of success of the procedure and the rates of vaginal delivery following successful ECV. It was a retrospective study of 669 patients diagnosed with breech at term, their clinical records were retrieved and data like age, BMI, parity, type of breech and scan findings noted. ECV was done in 256 patients and was successful in 35.5% of women with 51.1% being multigravidas and 26.8% in primigravidas. 76.9% of women with successful ECV delivered vaginally.  There was no significant fetal or maternal morbidity documented as a result of ECV in this study.

Entrapment of after-coming head in cesarean breech delivery of term pregnancy: A case report.

Nowadays, the majority of breech deliveries are by cesarean section. In Siriraj Hospital, planned vaginal breech delivery is not our current practice. Compared with vaginal breech delivery, cesarean section can significantly reduce neonatal complications, with a trivial increase in maternal complications. However, cesarean section cannot alleviate all of the complications. In the present report, a case with entrapment of after-coming head in cesarean breech delivery of a term fetus was described, and the management of this emergency condition was reviewed.

Clinical Trial of the Use of Moxibustion in Version for Breech Presentation / 日本東洋医学雑誌

Correction of fetal malpresentation such as knee-chest positioning and external cephalic version, has long been performed in cases of breech presentation. The reliability and safety of such treatment, however, remains unclear. We performed moxibustion on three acupoints, namely, Saninko, Shiin, and Yusen to correct the condition.<br>We studied a total of 28 women, 22 of whom were observed until delivery, and six who had not reached full term by the end of the study. Cephalic presentation was achieved in 25 (89.3%), All but one of the fetuses that were corrected to cephalic presentation had full term vaginal delivery. The remaining one underwent premature delivery due to premature rupture of the membrane at 35 weeks 6 days. None of the babies showed any abnormalities. Correction could not be achieved in three women by the time of delivery. One of these three had dicornate uterus and underwent caesarian section due to premature rupture of the membrane. The other two had full term vaginal delivery of live babies. These results indicate that the correction of breech presentation by moxibustion is a safe method which cause no adverse effects on the mother or baby.