Combined Assessment of the Obstetrical Conjugate and Fetal Birth Weight Predicts Birth Mode Outcome in Vaginally Intended Breech Deliveries of Primiparous Women—A Frabat Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Cohort and Patient Selection
2.2. Data Collection
2.3. Data Preparation
2.4. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Lr BW/CVO < 257.8 kg/cm n = 374 | HR BW/CVO ≥ 257.8 kg/cm n = 374 | p Value |
---|---|---|---|
Age (mean, standard deviation (SD); year (y)) | 31.4 (±3.8) | 31.2 (±4.1) | 0.795 |
BMI (mean, SD; kg/m2) | 22.6 (±3.5) | 23.3 (±3.6) | 0.001 |
Duration of pregnancy (mean, SD; days) | 277 (±8) | 282 (±7) | <0.001 |
Maternal preconditions | 57 (15.2%) | 43 (11.5%) | 0.133 |
Birth weight (mean, SD; gram) | 3064.7 (±261) | 3613.1 (±339) | <0.001 |
Obstetric conjugate (mean, SD; cm) | 13.14 (0.87) | 12.65 (0.82) | <0.001 |
Cesarean section rate (n, %) | 106 (28.3%) | 188 (50.3%) | <0.001 |
Epidural anesthesia | 232 (62.0%) | 259 (69.3%) | 0.038 |
Arterial umbilical chord pH < 7 | 4 (1.08%) | 1 (0.27%) | 0.177 |
5 min APGAR < 4 | 2 (0.6%) | 3 (0.4%) | 0.661 |
NICU > 4 days | 19 (5.1%) | (27 7.2%) | 0.223 |
Intubation > 24 h | 7 (1.9%) | 3 (0.8%) | 0.203 |
Neurological deficit | 2 (0.5%) | 2 (0.5%) | >0.99 |
Birth injury of the newborn | 3 (0.8%) | 4 (1.1%) | 0.704 |
Newborn Infection | 18 (4.8%) | 26 (7.0%) | 0.214 |
Congenital illness | 10 (2.7%) | 9 (2.4%) | 0.816 |
PREMODA Score | 21 (5.6%) | 28 (7.5%) | 0.301 |
PREMODA Score possibly related to birth mode | 8 (2.1%) | 13 (3.5%) | 0.268 |
Variable 1 | Variable 2 | r2 | p Value | Inverted Prediction CS-Rate = 0.3 | Inverted Prediction CS Rate = 0.5 |
---|---|---|---|---|---|
CS rate | BW/CVO ratio | 0.065 | <0.001 | 240.0 g/cm | 283.8 g/cm |
CS rate | Birth weight | 0.047 | <0.001 | 3039 g | 3691 g |
CS rate | CVO | 0.007 | 0.012 | 14.7 cm | 11.0 cm |
Characteristic | cLR BW/CVO < 257.8 kg/cm n = 106 | cHR BW/CVO ≥ 257.8 kg/cm n = 188 | p Value |
---|---|---|---|
Mother’s wish | 5 (4.7%) | 9 (4.8%) | 0.978 |
Birth arrest in stage I | 38 (35.9%) | 79 (42.2%) | 0.299 |
Birth arrest in stage II | 32 (30.2%) | 53 (28.2%) | 0.717 |
Non-reassuring fetal heart rate | 41 (38.7%) | 40 (21.3%) | 0.001 |
Prolapse of umbilical cord | 4 (3.8%) | 5 (2.7%) | 0.594 |
Feto-pelvical disproportion | 2 (1.9%) | 17 (9.0%) | 0.017 |
Suspected amniotic infection | 4 (3.8%) | 3 (1.6%) | 0.240 |
Characteristic | vLR BW/CVO < 257.8 kg/cm n = 218 | vHR BW/CVO ≥ 257.8 kg/cm n = 148 | p Value |
---|---|---|---|
Epidural anesthesia | 124 (56.9%) | 100 (67.6%) | 0.040 |
Manual assistance required | 91 (41.7%) | 73 (49.3%) | 0.152 |
Manually assisted head delivery (‘Frank Nudge’) | 84 (38.5%) | 69 (46.6%) | 0.124 |
Manually assisted arm delivery (‘Louwen maneuver’) | 39 (17.9%) | 37 (25.0%) | 0.100 |
Duration of Birth (mean, SD; minutes) | 414 (±260) | 557 (±331) | <0.001 |
PREMODA Score | 7 (3.2%) | 10 (6.8%) | 0.114 |
PREMODA Score possibly related to birth mode | 2 (0.9%) | 5 (3.4%) | 0.092 |
Non-perineal injuries (vaginal tear, labial or clitoral tear) | 85 (39.0%) | 67 (45.3%) | 0.232 |
Perineal injury | 126 (58.6%) | 79 (54.9%) | 0.482 |
III° and IV° Perineal injury | 4 (1.8%) | 6 (4.1%) | 0.201 |
Variable 1 | Variable 2 | r2 | p Value |
---|---|---|---|
Manual assistance | Birth weight/CVO | 0.0042 | 0.146 |
Manual assistance | Birth weight | 0.0045 | 0.135 |
Manual assistance | CVO | 0.0000 | 0.989 |
Assisted head delivery | Birth weight/CVO | 0.0044 | 0.141 |
Assisted head delivery | Birth weight | 0.0056 | 0.095 |
Assisted head delivery | CVO | 0.0002 | 0.766 |
Assisted arm delivery | Birth weight/CVO | 0.0147 | 0.020 |
Assisted arm delivery | Birth weight | 0.0215 | 0.005 |
Assisted arm delivery | CVO | 0.002 | 0.386 |
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Zander, N.; Raimann, F.J.; Al Naimi, A.; Brüggmann, D.; Louwen, F.; Jennewein, L. Combined Assessment of the Obstetrical Conjugate and Fetal Birth Weight Predicts Birth Mode Outcome in Vaginally Intended Breech Deliveries of Primiparous Women—A Frabat Study. J. Clin. Med. 2022, 11, 3201. https://doi.org/10.3390/jcm11113201
Zander N, Raimann FJ, Al Naimi A, Brüggmann D, Louwen F, Jennewein L. Combined Assessment of the Obstetrical Conjugate and Fetal Birth Weight Predicts Birth Mode Outcome in Vaginally Intended Breech Deliveries of Primiparous Women—A Frabat Study. Journal of Clinical Medicine. 2022; 11(11):3201. https://doi.org/10.3390/jcm11113201
Chicago/Turabian StyleZander, Nadja, Florian J. Raimann, Ammar Al Naimi, Dörthe Brüggmann, Frank Louwen, and Lukas Jennewein. 2022. "Combined Assessment of the Obstetrical Conjugate and Fetal Birth Weight Predicts Birth Mode Outcome in Vaginally Intended Breech Deliveries of Primiparous Women—A Frabat Study" Journal of Clinical Medicine 11, no. 11: 3201. https://doi.org/10.3390/jcm11113201
APA StyleZander, N., Raimann, F. J., Al Naimi, A., Brüggmann, D., Louwen, F., & Jennewein, L. (2022). Combined Assessment of the Obstetrical Conjugate and Fetal Birth Weight Predicts Birth Mode Outcome in Vaginally Intended Breech Deliveries of Primiparous Women—A Frabat Study. Journal of Clinical Medicine, 11(11), 3201. https://doi.org/10.3390/jcm11113201