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Is induction of labor a reasonable option for breech presentation?
Thomas Gaillard1,2,3, Aude Girault1,2,3,4, Sophie Alexander5
1Port Royal Maternity Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Acta Obstetricia Et Gynecologica Scandinavica
|February 7, 2019
Summary
Induction of labor for breech presentation is safe, showing no increased risk of neonatal mortality or morbidity compared to planned cesarean delivery. This finding supports induction as a viable option for breech births.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Maternal-Fetal Medicine
Background:
- Spontaneous labor and vaginal delivery for breech presentation are considered safe in select cases.
- The safety of labor induction for breech presentation remains less established.
- This study addresses the outcomes of induced labor versus planned cesarean delivery for breech presentation.
Purpose of the Study:
- To evaluate pregnancy outcomes in women with induced labor for breech presentation.
- To compare these outcomes with those of women undergoing planned cesarean delivery.
- To determine the safety of labor induction for singleton breech deliveries.
Main Methods:
- Secondary analysis of the prospective multicenter PREMODA study.
- Inclusion of singleton breech deliveries after 37 weeks gestation.
- Comparison of outcomes between induced labor and planned cesarean delivery groups.
Main Results:
- The study included 4138 women: 218 with induced labor and 3920 with planned cesarean.
- Vaginal delivery occurred in 67.4% of the induced labor group.
- No significant difference in the primary outcome (neonatal mortality and serious morbidity) between groups (1.4% vs 1.2%, P=0.75).
Conclusions:
- Induction of labor for breech presentation does not appear to increase neonatal mortality or severe neonatal morbidity.
- The findings suggest that induction is a safe option for breech presentation compared to planned cesarean.
- This supports considering induction of labor in carefully selected breech cases.
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