PubMed · 7456063
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K S Koss, P Bergsjø. 1980-11-30. [Time-studies in breech presentation].. https://pubmed.ncbi.nlm.nih.gov/7456063/
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OBJECTIVE: To evaluate the efficacy and complications of external cephalic version in term (37 or more weeks) gestation. STUDY DESIGN: A case series from February 1990 until December 1994 studied 160 patients with term singleton breech presentation. External cephalic version (ECV) with prophylactic tocolysis was the method used. RESULTS: ECV was successful in 67% of the cases (107/160) overall, in 56% of the nulliparous (57/102) and 86% of the multiparous women (50/58). About 90% of those with successful ECV (96/107) had a vaginal delivery with a vertex presentation of the fetus. Emergency Caesarean section due to fetal distress was not required during or immediately after the procedure. No perinatal mortality or babies with an Apgar score less than 7 at 5 min were observed. CONCLUSIONS: ECV in term pregnancy seems to be useful and it is safe both for the mother and the fetus. It should be performed at term, with close monitoring of the fetus, and in an environment able to provide an emergency Caesarean section.
Female carriers of Duchenne muscular dystrophy (DMD) may demonstrate elevated serum creatine kinase (CK) and reduction of muscle dystrophin in all muscle types. We hypothesized that decreased dystrophin in uterine or pelvic girdle musculature might affect the obstetrical performance of females heterozygous for a dystrophin mutation. We reviewed the outcome of 34 deliveries resulting in 35 children from 13 women who were mothers of males attending a muscular dystrophy clinic. Obstetrical performance was examined retrospectively by chart review and patient contact. Of 35 children, 6 (17%) were delivered in the breech position, which is a fivefold increase above the national standards for term pregnancies. Of the six infants with breech presentation, two were males affected with DMD, one was a female heterozygote, one was a male who died perinatally, and the carrier status of the other two females is unknown. Most DMD affected males (12/14) were delivered in the vertex position. Thus, it is likely that maternal, rather than fetal, muscle weakness was the significant factor in determination of fetal position at term. We speculate that subtle changes in uterine or pelvic girdle muscle tone may contribute to a higher rate of fetal breech position in carriers of the DMD gene.
The authors have investigated the data of 1009 neonates born from breech presentation in the I. Department of Obstetrics and Gynecology of Semmelweis Medical School between January 1., 1990 and December 31., 1995. The frequency of caesarean section in this group was 75.5%. In the subgroup of very small neonates (those under the birthweight of 1500 grams) caesarean section was performed in 71.4%. In this group 73.8% of the neonates were alive on the 28th postpartum day, as opposed to 37.7% in the group spontaneously delivered. The difference proved to be significant in the group weighing between 750 and 1249 grams. Intraventricular haemorrhage was also more frequent in the group spontaneously delivered. The difference was not significant in the groups under 750 grams and between 1250 and 1500 grams birthweight. Based on their investigation the authors conclude, that in the group of fetuses whose estimated birthweight is predicted to be between 750 and 1250 grams by ultrasound examination, perinatal mortality and morbidity rates in breech presentation can be improved by performing caesarean section.