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Related Experiment Video

Updated: Aug 9, 2025

External Cephalic Version: Is it an Effective and Safe Procedure?

External Cephalic Version: Is it an Effective and Safe Procedure?

Published on: June 6, 2020

Optimal time intervals for vaginal breech births: a case-control study.

Emma Spillane¹, Shawn Walker^2,3, Christine McCourt⁴

¹Maternity Services, Kingston NHS Foundation Trust, Kingston upon Thames, London, KT2 7QB, UK.

NIHR Open Research

|October 25, 2023

Summary

This summary is machine-generated.

Delays in breech birth emergence beyond Physiological Breech Birth Algorithm limits may predict adverse neonatal outcomes. Earlier recognition of normal emergence times can improve outcomes and potentially avoid harm.

Keywords:

Breech Presentation Case-Control Delivery: Breech Medical Education Midwifery Obstetrics Training

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Area of Science:

Obstetrics and Gynecology
Neonatal Medicine
Clinical Trial Methodology

Background:

Breech births carry a high risk of hypoxic injury due to potential cord occlusion.
The Physiological Breech Birth Algorithm proposes time intervals for earlier intervention.
This study aimed to test and refine the Algorithm for clinical trial application.

Purpose of the Study:

To evaluate the predictive accuracy of the Physiological Breech Birth Algorithm for adverse neonatal outcomes.
To identify specific time intervals within the Algorithm associated with increased risk.
To refine the Algorithm for improved clinical trial utility.

Main Methods:

Retrospective case-control study (15 cases, 30 controls) in a London teaching hospital (April 2012-April 2020).
Analysis of intrapartum care records using SPSS v26, focusing on labor and emergence time intervals.
Statistical analysis included chi-square tests, odds ratios, and multiple logistic regression to assess Algorithm adherence and outcomes.

Main Results:

Logistic regression modeling achieved 86.8% accuracy in predicting adverse outcomes based on Algorithm time frames.
Delays: umbilicus to head >3 minutes (OR: 9.508) and buttocks to head >7 minutes (OR: 6.682) were significant predictors.
Cases experienced longer intervention times and were more prone to delays than entrapment events.

Conclusions:

Exceeding Physiological Breech Birth Algorithm time limits may predict adverse neonatal outcomes.
Some delays in breech birth emergence are potentially avoidable.
Enhanced recognition of normal emergence parameters can improve clinical outcomes in vaginal breech births.