How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations]
Background OptiBreech collaborative care is a multi-disciplinary care pathway for breech presentation at term. The OptiBreech Multiple Trial Cohort is designed to host multiple trials related to care for breech presentation. This design enables prospective data collection for a large cohort of women...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
F1000 Research Ltd
2023-11-01
|
| Series: | NIHR Open Research |
| Subjects: | |
| Online Access: | https://openresearch.nihr.ac.uk/articles/3-61/v1 |
| _version_ | 1797217347742728192 |
|---|---|
| author | Sabrina Das Shawn Walker Amy Meadowcroft Kate Stringer Jacana Bresson Siân Davies Jasmine Kang Alice Hodder Emma Spillane |
| author_facet | Sabrina Das Shawn Walker Amy Meadowcroft Kate Stringer Jacana Bresson Siân Davies Jasmine Kang Alice Hodder Emma Spillane |
| author_sort | Sabrina Das |
| collection | DOAJ |
| description | Background OptiBreech collaborative care is a multi-disciplinary care pathway for breech presentation at term. The OptiBreech Multiple Trial Cohort is designed to host multiple trials related to care for breech presentation. This design enables prospective data collection for a large cohort of women planning a vaginal breech birth (VBB), to assess rare safety outcomes, while answering questions requiring a smaller, randomised sample nested within this cohort. Methods OptiBreech database currently contains participants recruited from 10 January 2022, including 67 women randomised to either OptiBreech care or standard care, and 116 women who received OptiBreech care and were not randomised. Primary outcomes included vaginal birth rate, composite neonatal morbidity and mortality and composite maternal neonatal morbidity and mortality. Descriptive statistics for the entire cohort were analysed in SPSS Version 29. Sub-group analyses were identified through participant involvement and engagement work as important to support informed decision-making. Results Of 97 women who planned a VBB at any point, 44 (45.4%) achieved a vaginal birth, compared to 29/77 (37.7%) of women who did not plan a VBB. Admission rates to a neonatal unit were similar, 4/97 (4.1%) versus 3/77 (3.9%). In this cohort, there was no severe neonatal morbidity following planned VBB, compared to 3/77 (3.9%) among the cohort who did not plan a vaginal breech birth and 2/52 (3.7%) among women who planned a cephalic birth. Severe maternal morbidity following planned VBB was 7/89 (7.9%), compared to 9/76 (11.8%) for women who did not plan a VBB and 8/54 (14.8%) for women who planned a cephalic birth. Conclusions Planning a VBB with OptiBreech collaborative care has thus far been as safe as not planning a VBB. Detecting differences in rare outcomes will require thousands of births. Outcomes will continue to be monitored and reported here as the cohort grows. |
| first_indexed | 2024-04-24T12:00:25Z |
| format | Article |
| id | doaj.art-080ed4cab54c44f195dade2b44ddf084 |
| institution | Directory Open Access Journal |
| issn | 2633-4402 |
| language | English |
| last_indexed | 2024-04-24T12:00:25Z |
| publishDate | 2023-11-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | NIHR Open Research |
| spelling | doaj.art-080ed4cab54c44f195dade2b44ddf0842024-04-09T00:00:00ZengF1000 Research LtdNIHR Open Research2633-44022023-11-01314650How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations]Sabrina Das0Shawn Walker1https://orcid.org/0000-0003-3658-8988Amy Meadowcroft2https://orcid.org/0000-0002-5934-0136Kate Stringer3Jacana Bresson4Siân Davies5Jasmine Kang6Alice Hodder7Emma Spillane8https://orcid.org/0000-0002-6663-7093Imperial College Health Partners, London, England, UKKing's College London, London, England, UKNorthern Care Alliance NHS Foundation Trust, Salford, England, UKSurrey and Sussex Healthcare NHS Trust, Redhill, England, UKKing's College London, London, England, UKKing's College London, London, England, UKKing's College London, London, England, UKKing's College London, London, England, UKKingston Hospital NHS Foundation Trust, London, England, UKBackground OptiBreech collaborative care is a multi-disciplinary care pathway for breech presentation at term. The OptiBreech Multiple Trial Cohort is designed to host multiple trials related to care for breech presentation. This design enables prospective data collection for a large cohort of women planning a vaginal breech birth (VBB), to assess rare safety outcomes, while answering questions requiring a smaller, randomised sample nested within this cohort. Methods OptiBreech database currently contains participants recruited from 10 January 2022, including 67 women randomised to either OptiBreech care or standard care, and 116 women who received OptiBreech care and were not randomised. Primary outcomes included vaginal birth rate, composite neonatal morbidity and mortality and composite maternal neonatal morbidity and mortality. Descriptive statistics for the entire cohort were analysed in SPSS Version 29. Sub-group analyses were identified through participant involvement and engagement work as important to support informed decision-making. Results Of 97 women who planned a VBB at any point, 44 (45.4%) achieved a vaginal birth, compared to 29/77 (37.7%) of women who did not plan a VBB. Admission rates to a neonatal unit were similar, 4/97 (4.1%) versus 3/77 (3.9%). In this cohort, there was no severe neonatal morbidity following planned VBB, compared to 3/77 (3.9%) among the cohort who did not plan a vaginal breech birth and 2/52 (3.7%) among women who planned a cephalic birth. Severe maternal morbidity following planned VBB was 7/89 (7.9%), compared to 9/76 (11.8%) for women who did not plan a VBB and 8/54 (14.8%) for women who planned a cephalic birth. Conclusions Planning a VBB with OptiBreech collaborative care has thus far been as safe as not planning a VBB. Detecting differences in rare outcomes will require thousands of births. Outcomes will continue to be monitored and reported here as the cohort grows.https://openresearch.nihr.ac.uk/articles/3-61/v1breech presentation physiological breech birth breech specialist midwives OptiBreech interim analysis cohort studyeng |
| spellingShingle | Sabrina Das Shawn Walker Amy Meadowcroft Kate Stringer Jacana Bresson Siân Davies Jasmine Kang Alice Hodder Emma Spillane How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations] NIHR Open Research breech presentation physiological breech birth breech specialist midwives OptiBreech interim analysis cohort study eng |
| title | How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_full | How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_short | How safe is it to plan a vaginal breech birth with OptiBreech collaborative care?: analysis of cumulative data within the OptiBreech Multiple Trials Cohort [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_sort | how safe is it to plan a vaginal breech birth with optibreech collaborative care analysis of cumulative data within the optibreech multiple trials cohort version 1 peer review 1 approved 2 approved with reservations |
| topic | breech presentation physiological breech birth breech specialist midwives OptiBreech interim analysis cohort study eng |
| url | https://openresearch.nihr.ac.uk/articles/3-61/v1 |
| work_keys_str_mv | AT sabrinadas howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT shawnwalker howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT amymeadowcroft howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT katestringer howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT jacanabresson howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT siandavies howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT jasminekang howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT alicehodder howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations AT emmaspillane howsafeisittoplanavaginalbreechbirthwithoptibreechcollaborativecareanalysisofcumulativedatawithintheoptibreechmultipletrialscohortversion1peerreview1approved2approvedwithreservations |