Practical insight into upright breech birth from birth videos: A structured analysis

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Surgical Skills Training

Background:

• Upright vaginal breech births require specific skills for optimal outcomes.
• Identifying common features aids in refining physiological approaches to breech birth management.

Purpose of the Study:

• To identify common features of successful upright vaginal breech births.
• To refine a physiological approach for teaching breech birth management.

Main Methods:

• Structured analysis of 42 videos of upright breech births.
• Facilitated by obstetricians and midwives across nine countries.
• Data analysis included time-to-event intervals and intervention frequencies using SPSS.

Main Results:

• 33% of births were completely spontaneous.
• Median time from fetal pelvis to head birth was 1:52.
• Lack of rotation by nipple line was linked to arm entrapment; various maneuvers were employed.

Conclusions:

• Most upright breech births conclude within 3 minutes of fetal pelvis delivery.
• Attendants utilize variations of established maneuvers.
• A physiological breech algorithm is proposed for teaching and practice.