Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Cohort and Patient Selection
2.2. Breech Birth Training
2.3. Data Collection
2.4. Statistical Analyses
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Cohort, N = 140 |
---|---|
Age (mean, st.dev.) | 32.2 (4.1) |
BMI (mean, st.dev.) | 22.6 (3.8) |
Duration of pregnancy in weeks | 40 (1) |
Parity (n, %) | |
1 | 72 (51.4) |
2 | 48 (34.3) |
>2 | 20 (14.3) |
Fetal birth weight (gram; mean, st.dev.) | 3340 (±412) |
PDA | 75 (54%) |
Perineal injury | 65 (46%) |
Delivery mode | |
Spontaneous vaginal birth | 77 (55%) |
Manually assisted birth | 63 (45%) |
Manually assisted birth in dorsal position | 28 (20%) |
Variable | 1 N = 20 | 2 N = 20 | 3 N = 20 | 4 N = 20 | 5 N = 20 | 6 N = 20 | 7 N = 20 | p-Value |
---|---|---|---|---|---|---|---|---|
Experience | 2 | 1 | 2 | 2 | 1 | 0 | 0 | |
Parity | 0.195 | |||||||
1 | 12 (60%) | 14 (70%) | 11 (55%) | 10 (50%) | 10 (50%) | 10 (50%) | 5 (24%) | |
2 | 5 (25%) | 4 (20%) | 4 (20%) | 8 (40%) | 9 (45%) | 6 (30%) | 12 (60%) | |
>2 | 3 (15%) | 2 (10%) | 5 (25%) | 2 (10%) | 1 (5%) | 4 (20%) | 3 (15%) | |
BMI (mean, st.dev.) | 23.6 (±3.2) | 22.1 (±1.8) | 21.6 (±3.1) | 22.1 (±4.6) | 24.9 (±6.2) | 22.1 (±2.9) | 22.0 (±2.4) | 0.06 |
Fetal birth weight (gram; mean, st.dev.) | 3333 (±363) | 3382 (±435) | 3274 (402) | 3263 (±351) | 3471 (±385) | 3283 (±427) | 3379 (±524) | 0.707 |
PDA | 10 (50%) | 11 (55%) | 12 (60%) | 10 (50%) | 16 (80%) | 7 (35%) | 9 (45%) | 0.146 |
Perineal injury | 10 (50%) | 11 (55%) | 6 (30%) | 9 (45%) | 14 (70%) | 8 (40%) | 7 (35%) | 0.189 |
Delivery mode | 0.006 | |||||||
Spontaneous vaginal birth | 16 (80%) | 7 (35%) | 13 (65%) | 10 (50%) | 5 (35%) | 13 (65%) | 13 (65%) | |
Manually assisted birth | 4 (20%) | 13 (65%) | 7 (35%) | 10 (50%) | 15 (65%) | 7 (35%) | 7 (35%) |
Variable | EG0 (N = 40) | EG1 (N = 40) | EG2 (N = 60) | p-Value |
---|---|---|---|---|
Parity (n, %) | 0.196 | |||
1 | 15 (37.5%) | 24 (60%) | 33 (55%) | |
2 | 18 (45%) | 13 (32.5%) | 17 (28.3%) | |
>2 | 7 (17.5%) | 3 (7.5%) | 10 (7.5%) | |
Fetal birth weight (gramm; mean, st.dev.) | 3331 (475) | 3426 (408) | 3290 (368) | 0.287 |
NICU > 4 days | 3 (7.5%) | 2 (5%) | 4 (6.7%) | 0.897 |
5 min APGAR < 4 | 1 (2.5%) | 0 (0.0%) | 0 (0.0%) | 0.284 |
Intubation > 24 h | 1 (2.5%) | 0 (0%) | 1 (1.7%) | 0.628 |
Fetal infection | 2 (5%) | 3 (7.5%) | 3 (5%) | 0.847 |
Mod. PREMODA Score | 4 (10%) | 5 (12.5%) | 4 (6.7%) | 0.606 |
Mod. PREMODA Score possibly related to birth mode | 2 (5%) | 3 (7.5%) | 1 (1.7%) | 0.357 |
Manual assistance | 14 (35%) | 28 (70%) | 21 (35%) | 0.0008 |
Help with delivery of arms | 7 (17.5%) | 24 (60%) | 13 (21.7%) | <0.0001 |
Help with delivery of the head | 11 (27.5%) | 24 (60%) | 19 (31.7%) | 0.004 |
Frank Nudge | 9 (22.5%) | 2 (5%) | 7 (11.7%) | 0.061 |
Dorsal position | 1 (2.5%) | 19 (47.5%) | 9 (15%) | <0.0001 |
PDA | 16 (40%) | 27 (67.5%) | 32 (53.3%) | 0.048 |
Perineal injury | 15 (37.5%) | 25 (62.5%) | 25 (41.7%) | 0.050 |
Variable | Deliveries 1–10 (N = 70) | Deliveries 11–20 (N = 70) | p-Value |
---|---|---|---|
Parity (n, %) | 0.308 | ||
1 | 34 (48.6%) | 38 (54.3) | |
2 | 29 (40%) | 20 (28.6%) | |
>2 | 8 (11.4%) | 12 (17.4%) | |
Fetal birth weight (gram; mean, st.dev.) | 3345 (370) | 3336 (454) | 0.796 |
NICU > 4 days | 4 (5.7%) | 5 (7.1%) | 0.730 |
5 min APGAR < 4 | 0 (0%) | 1 (1.4%) | 0.316 |
Intubation >24 h | 1 (1.43%) | 1 (1.43%) | 1.000 |
Fetal infection | 3 (4.3%) | 5 (7.1%) | 0.467 |
Mod. PREMODA Score | 6 (8.6%) | 7 (10%) | 0.771 |
Mod. PREMODA Score possibly related to birth mode | 3 (4.3%) | 3 (4.3%) | 1.000 |
Manual assistance | 23 (32.9%) | 40 (57.1%) | 0.004 |
Help with delivery of arms | 18 (25.7%) | 26 (37.1%) | 0.145 |
Help with delivery of the head | 21 (30%) | 33 (47.1%) | 0.037 |
Frank Nudge | 4 (5.7%) | 14 (20%) | 0.012 |
Dorsal position | 11 (15.71%) | 18 (25.7%) | 0.144 |
PDA | 31 (44.3%) | 44 (62.9%) | 0.028 |
Perineal injury | 35 (50%) | 30 (42.9%) | 0.718 |
Variable | Deliveries 1–10 | Deliveries 11–20 | p-Value |
---|---|---|---|
(A) Experience = 0 | N = 20 | N = 20 | |
Mod. PREMODA poss. related to BM | 0 (0%) | 2 (10%) | 0.147 |
Manual assistance | 3 (15%) | 11 (55%) | 0.0080 |
Help with delivery of arms | 2 (10%) | 5 (25%) | 0.212 |
Help with delivery of the head | 1 (5%) | 10 (50%) | 0.0014 |
Frank Nudge | 0 (0%) | 9 (45%) | 0.0007 |
Dorsal position | 0 (0%) | 1 (5%) | 0.311 |
PDA | 7 (35%) | 9 (45%) | 0.519 |
Perineal injury | 8 (40%) | 7 (35%) | 0.744 |
(B) Experience = 1 | N = 20 | N = 20 | |
Mod. PREMODA poss. related to BM | 2 (10%) | 1 (5%) | 0.548 |
Manual assistance | 11 (55%) | 17 (85%) | 0.0384 |
Help with delivery of arms | 10 (50%) | 14 (70%) | 0.197 |
Help with delivery of the head | 11 (55%) | 13 (65%) | 0.519 |
Frank Nudge | 2 (10%) | 0 (0%) | 0.147 |
Dorsal position | 8 (40%) | 11 (55%) | 0.342 |
PDA | 14 (70%) | 13 (65%) | 0.736 |
Perineal injury | 13 (65%) | 12 (60%) | 0.774 |
(C) Experience = 2 | N = 20 | N = 20 | |
Mod. PREMODA poss. related to BM | 1 (0%) | 0 (0%) | 0.313 |
Manual assistance | 9 (30%) | 12 (40%) | 0.417 |
Help with delivery of arms | 6 (20%) | 7 (23.3%) | 0.754 |
Help with delivery of the head | 9 (30%) | 10 (33.3%) | 0.781 |
Frank Nudge | 2 (6.7%) | 5 (16.7%) | 0.228 |
Dorsal position | 3 (10%) | 6 (20%) | 0.278 |
PDA | 10 (33.3%) | 22 (73.3%) | 0.002 |
Perineal injury | 14 (46.7%) | 11 (36.7%) | 0.432 |
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Jennewein, L.; Brüggmann, D.; Fischer, K.; Raimann, F.J.; Pfeifenberger, H.R.; Agel, L.; Zander, N.; Eichbaum, C.; Louwen, F. Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study. J. Clin. Med. 2021, 10, 2117. https://doi.org/10.3390/jcm10102117
Jennewein L, Brüggmann D, Fischer K, Raimann FJ, Pfeifenberger HR, Agel L, Zander N, Eichbaum C, Louwen F. Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study. Journal of Clinical Medicine. 2021; 10(10):2117. https://doi.org/10.3390/jcm10102117
Chicago/Turabian StyleJennewein, Lukas, Dörthe Brüggmann, Kyra Fischer, Florian J. Raimann, Hemma Roswitha Pfeifenberger, Lena Agel, Nadja Zander, Christine Eichbaum, and Frank Louwen. 2021. "Learning Breech Birth in an Upright Position Is Influenced by Preexisting Experience—A FRABAT Prospective Cohort Study" Journal of Clinical Medicine 10, no. 10: 2117. https://doi.org/10.3390/jcm10102117