Cephalic extraction versus breech extraction in second-stage caesarean section: a retrospective study.
Cephalic extraction
push-pull
second-stage caesarean section
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
accepted:
29
04
2020
pubmed:
15
5
2020
medline:
30
10
2020
entrez:
15
5
2020
Statut:
ppublish
Résumé
Our primary objective was to compare maternal and neonatal outcomes based on the attempted mode of extraction. Our secondary objective was to compare the outcomes based on the actual mode of extraction. A retrospective cohort study at a single tertiary centre between the years 2011 and 2019. The study included 1028 cases of term pregnancies in vertex presentation that were delivered by caesarean section at the second stage of delivery. Patients were grouped according to the attempted mode of extraction: attempted cephalic extraction (674) and breech extraction (354). A subgroup analysis was conducted, comparing successful cephalic extraction (615), failed cephalic extraction (59) and breech extraction (354). Both maternal and neonatal complication rates were compared between the groups. There were significantly more uterine incision extensions (27.4 versus 11.9%, P < 0.001) and increased need for blood transfusion (10.7 versus 6.2%, P = 0.018) in the cephalic extraction compared with the breech extraction group. The highest rate of uterine incision extensions (45.8%) and need for blood transfusion (22%) was in the subgroup of failed cephalic extraction. The rate of adverse neonatal outcomes was comparable between the two groups. However, in the subgroup of failed cephalic extraction, there were higher rates of low 1-minute Apgar scores, NICU hospitalisation and limb fractures compared with successful cephalic extractions and breech extractions (P = 0.016, 0.01, <0.001, respectively). Breech extraction in second-stage caesarean section is associated with fewer maternal complications compared wiith attempted cephalic extraction without increasing neonatal complication rates. In breech versus cephalic extraction, breech extraction was found to have better outcomes in second-stage caesarean section.
Identifiants
pubmed: 32406174
doi: 10.1111/1471-0528.16314
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1568-1574Informations de copyright
© 2020 Royal College of Obstetricians and Gynaecologists.
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