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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

01-12-2020 | Care | Research article

Impact of implementation of a breech clinic in a tertiary hospital

Authors: S. Derisbourg, E. Costa, L. De Luca, S. Amirgholami, V. Bogne Kamdem, A. Vercoutere, W. H. Zhang, S. Alexander, P. M. Buekens, Y. Englert, A. Pintiaux, C. Daelemans

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

The incidence of breech presentation in single pregnancies at term is between three to 5 %. In order to support eligible women in their choice of mode of delivery, a dedicated breech clinic with a care pathway was developed in December 2015 in a tertiary referral centre in Brussels.
The primary objective of this study was to evaluate the vaginal birth rate before and after the introduction of a dedicated breech clinic. The secondary objective was to compare the early neonatal outcomes before and after the breech clinic was introduced.

Methods

This was a single centre retrospective and prospective study. The inclusion criteria were term (from 37 weeks), singleton fetus and breech presentation at delivery. The exclusion criteria were suspected intrauterine growth restriction, severe fetal malformations and intrauterine fetal demise. We used a composite outcome as an indicator of neonatal morbidity and mortality.

Results

After the introduction of the breech clinic, we observed a significant increase in planned vaginal delivery from 7.4% (12/162) to 53.0% (61/115) (OR: 13.5; 95% CI: 6.7–27.0). The effective vaginal breech delivery rate (planned and unexpected) significantly increased from 4.3% (7/162) pre-implementation of breech clinic to 43.5% (50/115) post-implementation (OR: 17.0; 95% CI: 7.3–39.6). Neonatal outcomes were not statistically different between the before and after periods.

Conclusion

The introduction of a dedicated breech clinic has led to an increase in vaginal deliveries for breech babies without adversely affecting neonatal outcomes.
Appendix
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Metadata
Title
Impact of implementation of a breech clinic in a tertiary hospital
Authors
S. Derisbourg
E. Costa
L. De Luca
S. Amirgholami
V. Bogne Kamdem
A. Vercoutere
W. H. Zhang
S. Alexander
P. M. Buekens
Y. Englert
A. Pintiaux
C. Daelemans
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03122-4

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