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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| Format: | Article |
| Language: | English |
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MDPI AG
2021-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/10/2117 |
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| author | Lukas Jennewein Dörthe Brüggmann Kyra Fischer Florian J. Raimann Hemma Roswitha Pfeifenberger Lena Agel Nadja Zander Christine Eichbaum Frank Louwen |
| author_facet | Lukas Jennewein Dörthe Brüggmann Kyra Fischer Florian J. Raimann Hemma Roswitha Pfeifenberger Lena Agel Nadja Zander Christine Eichbaum Frank Louwen |
| author_sort | Lukas Jennewein |
| collection | DOAJ |
| 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%; <i>p</i> = 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%; <i>p</i> = 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. |
| first_indexed | 2024-03-10T11:25:44Z |
| format | Article |
| id | doaj.art-4f94ea2bb70242df823c379675d10f47 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T11:25:44Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4f94ea2bb70242df823c379675d10f472023-11-21T19:40:40ZengMDPI AGJournal of Clinical Medicine2077-03832021-05-011010211710.3390/jcm10102117Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort StudyLukas Jennewein0Dörthe Brüggmann1Kyra Fischer2Florian J. Raimann3Hemma Roswitha Pfeifenberger4Lena Agel5Nadja Zander6Christine Eichbaum7Frank Louwen8Department of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, GermanyDepartment of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, GermanyDepartment of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, GermanyDepartment of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, 60590 Frankfurt, GermanyDepartment of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, GermanyCarl Remigus Medical School, Limburger Straße 2, 65510 Idstein, GermanyCarl Remigus Medical School, Limburger Straße 2, 65510 Idstein, GermanyDepartment of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, GermanyDepartment of Gynecology and Obstetrics, School of Medicine, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt, GermanyBackground: 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%; <i>p</i> = 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%; <i>p</i> = 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.https://www.mdpi.com/2077-0383/10/10/2117vaginal breechdelivery modeclinical teaching |
| spellingShingle | Lukas Jennewein Dörthe Brüggmann Kyra Fischer Florian J. Raimann Hemma Roswitha Pfeifenberger Lena Agel Nadja Zander Christine Eichbaum Frank Louwen Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study Journal of Clinical Medicine vaginal breech delivery mode clinical teaching |
| 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 | vaginal breech delivery mode clinical teaching |
| url | https://www.mdpi.com/2077-0383/10/10/2117 |
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