Breech Presentation: A malpresentation of the FETUS at near term or during OBSTETRIC LABOR with the fetal cephalic pole in the fundus of the UTERUS. There are three types of breech: the complete breech with flexed hips and knees; the incomplete breech with one or both hips partially or fully extended; the frank breech with flexed hips and extended knees.Version, Fetal: The artificial alteration of the fetal position to facilitate birth.Cesarean Section: Extraction of the FETUS by means of abdominal HYSTEROTOMY.Labor Presentation: The position or orientation of the FETUS at near term or during OBSTETRIC LABOR, determined by its relation to the SPINE of the mother and the birth canal. The normal position is a vertical, cephalic presentation with the fetal vertex flexed on the NECK.Delivery, Obstetric: Delivery of the FETUS and PLACENTA under the care of an obstetrician or a health worker. Obstetric deliveries may involve physical, psychological, medical, or surgical interventions.Fetal Distress: A nonreassuring fetal status (NRFS) indicating that the FETUS is compromised (American College of Obstetricians and Gynecologists 1988). It can be identified by sub-optimal values in FETAL HEART RATE; oxygenation of FETAL BLOOD; and other parameters.Infant, Postmature: An infant born at or after 42 weeks of gestation.Pelvimetry: Measurement of the dimensions and capacity of the pelvis. It includes cephalopelvimetry (measurement of fetal head size in relation to maternal pelvic capacity), a prognostic guide to the management of LABOR, OBSTETRIC associated with disproportion.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Dystocia: Slow or difficult OBSTETRIC LABOR or CHILDBIRTH.Cesarean Section, Repeat: Extraction of the fetus by abdominal hysterotomy anytime following a previous cesarean.Parity: The number of offspring a female has borne. It is contrasted with GRAVIDITY, which refers to the number of pregnancies, regardless of outcome.Pregnancy Outcome: Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; SPONTANEOUS ABORTION; INDUCED ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.Infant, Newborn: An infant during the first month after birth.Birth Weight: The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms.Gestational Age: The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.Ultrasonography, Prenatal: The visualization of tissues during pregnancy through recording of the echoes of ultrasonic waves directed into the body. The procedure may be applied with reference to the mother or the fetus and with reference to organs or the detection of maternal or fetal disease.Fitness Centers: Facilities having programs intended to promote and maintain a state of physical well-being for optimal performance and health.Moxibustion: The burning of a small, thimble sized, smoldering plug of dried leaves on the SKIN at an ACUPUNCTURE point. Usually the plugs contain leaves of MUGWORT or moxa.Acupuncture Therapy: Treatment of disease by inserting needles along specific pathways or meridians. The placement varies with the disease being treated. It is sometimes used in conjunction with heat, moxibustion, acupressure, or electric stimulation.Heart Rate, Fetal: The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.Cardiotocography: Monitoring of FETAL HEART frequency before birth in order to assess impending prematurity in relation to the pattern or intensity of antepartum UTERINE CONTRACTION.Fetal Monitoring: Physiologic or biochemical monitoring of the fetus. It is usually done during LABOR, OBSTETRIC and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery.Nonlinear Dynamics: The study of systems which respond disproportionately (nonlinearly) to initial conditions or perturbing stimuli. Nonlinear systems may exhibit "chaos" which is classically characterized as sensitive dependence on initial conditions. Chaotic systems, while distinguished from more ordered periodic systems, are not random. When their behavior over time is appropriately displayed (in "phase space"), constraints are evident which are described by "strange attractors". Phase space representations of chaotic systems, or strange attractors, usually reveal fractal (FRACTALS) self-similarity across time scales. Natural, including biological, systems often display nonlinear dynamics and chaos.Chiropractic: An occupational discipline founded by D.D. Palmer in the 1890's based on the relationship of the spine to health and disease.Manipulation, Chiropractic: Procedures used by chiropractors to treat neuromusculoskeletal complaints.Trigger Points: Discrete spots in taut bands of muscle that produce local and referred pain when muscle bands are compressed.Melissa: A plant genus of the family LAMIACEAE. The common names of beebalm or lemonbalm are also used for MONARDA.Vaginal Birth after Cesarean: Delivery of an infant through the vagina in a female who has had a prior cesarean section.Live Birth: The event that a FETUS is born alive with heartbeats or RESPIRATION regardless of GESTATIONAL AGE. Such liveborn is called a newborn infant (INFANT, NEWBORN).

Should a preterm breech go for vaginal delivery or caesarean section. (1/92)

This study correlates the mode of breech delivery to the immediate neonatal outcome in preterm breeches. We had 9816 deliveries in the period between 1st January 1994 to 31st August 1996. The incidence of breech deliveries was 3.95% and the incidence of preterm breech deliveries was 1.9%. Totally 112 (69%) patients delivered vaginally and 50 (31%) underwent caesarean section. Between 30-36.6 weeks gestation the incidence of birth asphyxia was higher in the vaginal group. In this group the take home baby rate after vaginal delivery was 81% as compared to 86% in caesarean group. Head entrapment, cord prolapse, respiratory distress syndrome and intraventricular haemorrhage were the various complications seen with vaginal breech delivery.  (+info)

Birth trauma to muscles in babies born by breech delivery and its possible fatal consequences. (2/92)

Dissection and histological examination was made of the muscles of 86 babies who died after breech delivery, and of 38 babies who died after vertex presentation. A control group of 50 surviving breech-delivered babies was examined clinically and the results compared. It was concluded that the most common type of birth trauma to a baby born by breech delivery is injury to muscles and soft tissues of the back and lower extremities, which is often extensive. In some severly injured babies histological examination of organs revels signs of crush syndrome and disseminated intravascular coagulation. It is suggested that the extensive muscle trauma forms the background of these fatal conditions.  (+info)

A decision analytical cost analysis of offering ECV in a UK district general hospital. (3/92)

OBJECTIVE: To determine the care pathways and implications of offering mothers the choice of external cephalic version (ECV) at term for singleton babies who present with an uncomplicated breech pregnancy versus assisted breech delivery or elective caesarean. DESIGN: A prospective observational audit to construct a decision analysis of uncomplicated full term breech presentations. SETTING: The North Staffordshire NHS Trust. SUBJECTS: All women (n = 176) who presented at full term with a breech baby without complications during July 1995 and June 1997. MAIN OUTCOME MEASURES: The study determined to compare the outcome in terms of the costs and cost consequences for the care pathways that resulted from whether a women chose to accept the offer of ECV or not. All the associated events were then mapped for the two possible pathways. The costs were considered only within the hospital setting, from the perspective of the health care provider up to the point of delivery. RESULTS: The additional costs for ECV, assisted breech delivery and elective caesarean over and above a normal birth were 186.70 pounds sterling, 425.36 pounds sterling and 1,955.22 pounds sterling respectively. The total expected cost of the respective care pathways for "ECV accepted" and "ECV not accepted" (including the probability of adverse events) were 1,452 pounds sterling and 1,828 pounds sterling respectively, that is the cost of delivery through the ECV care pathways is less costly than the non ECV delivery care pathway. CONCLUSIONS: Implementing an ECV service may yield cost savings in secondary care over and above the traditional delivery methods for breech birth of assisted delivery or caesarean section. The scale of these expected cost savings are in the range of 248 pounds sterling to 376 pounds sterling per patient. This converts to a total expected cost saving of between 43,616 pounds sterling and 44,544 pounds sterling for the patient cohort considered in this study.  (+info)

Role of pelvimetry in active management of labour. (4/92)

All cases referred for pelvimetry in 1970-1 and all breech presentations referred for pelvimetry in 1972-4 were reviewed. Indications for pelvimetry fell into four main categories: high head in the antenatal clinic (47-8%); high head in labour (13-9%); breech presentation (20-9%); and previous caesarean section (14-8%). In the first two categories pelvimetry rarely if ever influenced management, and it should not be performed routinely. In breech presentation and cases of caesarean section pelvimetry seemed to be of value, but in the latter group it should be performed puerperally to avoid the known radiation hazard to the fetus. A fairly close correlation between obstetric conjugate and pelvic capacity was shown, which suggested that a 3400-g baby might pass through a pelvis of obstetric conjugate of 10 cm as a cephalic trial of labour, but would need an obstetric conjugate of 11-7 cm for safe vaginal breech delivery.  (+info)

Moxibustion in breech version--a descriptive review. (5/92)

The management of breech presentation at term remains controversial. It appears logical that maternal and perinatal outcomes would be improved if breech presentation could be avoided. External cephalic version is considered a safe procedure if cases are selected appropriately and anaesthesia avoided. Moxibustion is a traditional Chinese method of treatment, which utilizes the heat generated by burning herbal preparations containing the plant Artemisia vulgaris to stimulate the acupuncture points. It is used for breech version with a reported success rate of 84.6% after 34 weeks gestation. Moxibustion technique is cheap, safe, simple, self-administered, non-invasive, painless and generally well tolerated. Although many studies give encouraging results regarding the use of moxibustion in inducing cephalic version of breech presentation, a definitive conclusion cannot be made as most involve small sample sizes and are not randomised. Moxibustion could be an extra option offered to women with breech presentation along with vaginal delivery, caesarean section and external cephalic version. This article discusses the possible role of moxibustion in correction of breech presentation in the hope that, some interest will be stimulated in what is a very interesting area for future research.  (+info)

Obstetric outcome among women with unexplained infertility after IVF: a matched case-control study. (6/92)

BACKGROUND: Infertility itself and also assisted reproductive treatment increase the incidence of some obstetric complications. Women with unexplained infertility are reported to be at an increased risk of intrauterine growth restriction during pregnancy, but not for other perinatal complications. METHODS: A matched case-control study was performed on care during pregnancy and delivery, obstetric complications and infant perinatal outcomes of 107 women with unexplained infertility, with 118 clinical pregnancies after IVF or ICSI treatment. These resulted in 90 deliveries; of these, 69 were singleton, 20 twin and one triplet. Two control groups were chosen from the Finnish Medical Birth Register, one group for spontaneous pregnancies (including 445 women and 545 children), matched according to maternal age, parity, year of birth, mother's residence and number of children at birth, and the other group for all pregnancies after IVF, ICSI or frozen embryo transfer treatment (FET) during the study period (including 2377 women and 2853 children). RESULTS: Among singletons, no difference was found in the mean birthweight, and the incidence of low birthweight (<2500 g) was comparable with that of the control groups. No differences were found in gestational duration, major congenital malformations or perinatal mortality among the groups studied. Among singletons in the study group, there were more term breech presentations (10.1%) compared with both spontaneously conceiving women and all IVF women (P < 0.01). The rate of pregnancy-induced hypertension was significantly lower among singletons in the study group (P < 0.05) compared with other IVF singletons. The multiple pregnancy rate was 23.3% in the study group. The obstetric outcome of the IVF twins was similar to both control groups. CONCLUSIONS: The overall obstetric outcome among couples with unexplained infertility treated with IVF was good, with similar outcome compared with spontaneous pregnancies and IVF pregnancies generally.  (+info)

Erich Bracht (1882-1969) of Berlin and his "breech" manoeuvre. (7/92)

Erich Bracht, a German gynaecologist, described in 1935 the manoeuvre named after him for delivering the frank breech with minimal interference. In spite of the reported success of his method, it received little attention in the United Kingdom or North America.  (+info)

Introducing routine external cephalic version for the management of the malpresenting fetus near term. (8/92)

BACKGROUND: The aim of this study was to assess the efficacy and safety of external cephalic version (ECV) when its use was introduced in the routine management of breech presentation and transverse lie after 36 weeks by obstetricians with limited prior experience with the procedure. The influence of various factors on the outcome of ECV was also studied. METHODS: Retrospective study of 44 consecutive cases of ECV which were analysed with respect to outcome, parity, type of breech, placental site and birth weight. RESULTS: ECV was successful in 45% of women, 80% of women with successful ECV delivered vaginally while 10% underwent spontaneous reversion to a non-cephalic presentation. In contrast, only 15% of women with failed ECV delivered vaginally. Parity, type of breech presentation and placental location did not significantly affect the outcome of ECV although there was a trend towards better success rate of ECV with multiparity, flexed breech presentation, transverse lie and posteriorly-located placentae. The mean birth weight of fetuses of women with successful ECV was significantly heavier than those of women who failed ECV (p < 0.001). No significant fetal or maternal morbidity occurred as a result of ECV in this study. CONCLUSION: ECV is a safe and effective procedure that is useful in the management of breech presentation and transverse lie near term. The lack of prior experience with the procedure does not appear to influence the success rate or morbidity.  (+info)

  • A baby is considered breech when their "buttocks, feet, or both," are positioned to come out of the birth canal first, according to the American College of Obstetricians and Gynecologists (ACOG), which the organization reported happens in approximately 3 to 4% of full-term births. (
  • Apprenez-en davantage sur les accouchements par le siège et les accouchements où le bébé adopte une position inhabituelle dans l'utérus, comme la position postérieure et la position transverse. (
  • Dans certains cas, le bébé pourrait se présenter par le siège, en position postérieure, de face ou en position transverse. (
  • The outcomes of all pregnancies with a breech presentation after 37 weeks of gestation were retrospectively reviewed from January 1997 to June 2000. (
  • Safe vaginal breech delivery at term can be achieved with strict selection criteria, adherence to a careful intrapartum protocol, and with an experienced obstetrician in attendance. (
  • TY - JOUR T1 - Singleton vaginal breech delivery at term: still a safe option. (
  • According to Pieter Treffers and Maria Pel, two obstetricians from the Academic Medical Centre in Amsterdam, who reviewed the book in the British Medical Journal (23 October 1993), the increase is also due to the attitude among British obstetricians over whether elective caesarean delivery should be given in cases of babies in breech presentation or women who'd had a previous caesarean. (
  • Patients of group B had also a high incidence of perinatal insults (12/15, 80%), but breech delivery was markedly less frequent (13.33 vs. 68.18% of group A) and responsible for only IGHD. (
  • The limiting factor with vaginal delivery is physician experience and skill, so that is a conversation that you must have with your physician once the breech is diagnosed in the late third trimester. (
  • What do you choose for breech baby and delivery? (
  • Should Acupuncture And Moxibustion Be Routinely Recommended For The Treatment Of Breech Presentation? (
  • If interested, you can contact your local holistic practitioner about the possibility of using of Moxibustion or Pulsatilla to correct a breech position. (
  • (
  • One of the benefits of moxibustion as a treatment for breech is that it has been shown in systematic reviews to be very safe. (
  • Obstetrical regulating bodies such as the Royal College of Obstetricians and Gynecologists are now recommending moxibustion as an additional tool for breech presentation. (
  • Moxibustion is a type of Chinese medicine that may be helpful in turning a breech baby. (
  • This review found limited evidence to support the use of moxibustion for correcting breech presentation. (
  • Moxibustion (a type of Chinese medicine which involves burning a herb close to the skin) to the acupuncture point Bladder 67 (BL67) (Chinese name Zhiyin ), located at the tip of the fifth toe, has been proposed as a way of correcting breech presentation. (
  • Objective: A systematic review of studies assessing the effectiveness of acupuncture-type interventions (moxibustion, acupuncture, or electro-acupuncture) on acupuncture point BL 67 to correct breech presentation compared to expectant management, based on controlled trials. (
  • It is claimed that moxibustion mitigates against cold and dampness in the body, and can serve to turn breech babies . (
  • Moxibustion, acupuncture and other acupoint stimulations are commonly used for the correction of breech presentation. (
  • This systematic review aims to evaluate the efficacy and safety of moxibustion and other acupoint stimulations to treat breech presentation. (
  • We included randomized controlled trials (RCTs) and controlled clinical trials (CCTs) on moxibustion, acupuncture or any other acupoint stimulating methods for breech presentation in pregnant women. (
  • Moxibustion, acupuncture and laser acupoint stimulation tend to be effective in the correction of breech presentation. (
  • In China, moxibustion on Zhiyin (BL67) point has long been used to correct abnormal foetal position and is widely used to correct breech presentation in obstetrics. (
  • Moxibustion and other acupoint stimulation methods such as acupuncture and laser stimulation were found to be effective to treat breech presentation. (
  • All 128 women admitted during the study period to the obstetrics department of a tertiary care military hospital in Taif, Saudi Arabia with breech presentation at term, regardless of age and parity, who accepted ECV were recruited. (
  • In a breech presentation, the body comes out first, leaving the baby's head to be delivered last. (
  • Pregnant women with breech presentation at term in the region of Eindhoven, The Netherlands. (
  • revisar los conceptos que subyacen al trabajo de parto con feto en presentación pelviana, su semiología y las maniobras obstétricas que facilitan un resultado materno perinatal exitoso. (
  • el mecanismo del parto en presentación pelviana es complejo y requiere, cuando no hay otra alternativa para la atención , que tanto el obstetra como el médico general conozcan su fisiología y las múltiples maniobras obstétricas que facilitan obtener buen resultado materno perinatal. (
  • It is very well understood, however, that there are certain conditions that significantly increase the risk of breech presentation occurring. (
  • What are the causes of breech presentation? (
  • Causes of breech presentation include premature labor, uterine malformations and fetal abnormalities. (
  • When a formal diagnosis of breech presentation is made doctors must make a pivotal decision. (
  • Conclusions: Our results suggest that acupuncture-type interventions on BL 67 are effective in correcting breech presentation compared to expectant management. (
  • Acupuncture is successful in turning breech presentation babies in about 70% of cases, according to research. (
  • The majority of women with a breech presentation did not receive ECV. (