Abstract：
OBJECTIVE: To study neonatal and maternal outcomes associated with routine maneuvers in breech vaginal delivery at term.
METHODS: This was a secondary analysis of the multicenter PREMODA observational prospective study in France and Belgium. We included women with vaginal breech delivery, excluding those who underwent maneuvers to resolve a dystocic delivery. Maternal data and characteristics of labor, in addition to neonatal and maternal outcomes, were recorded. We defined two groups according to mode of delivery; breech vaginal delivery with or without routine maneuvers, and we compared the variables between the groups. To assess the factors associated with adverse perinatal outcomes, a multivariate logistic regression with adjustment for confounders was performed.
RESULTS: Of the 2502 women with planned vaginal deliveries, 1794 were delivered vaginally, 606 of whom were excluded from the study due to maneuvers performed for dystocia. A total of 25 other patients were excluded as a result of missing data. A total of 537 women were included in the routine maneuvers group and 626 women in the no maneuvers group. Adverse perinatal outcome was similar for the two groups (4.5% vs 5.0%, P = 0.65) and no neonatal deaths were reported. Third degree perineal tear and postpartum hemorrhage >1 L rates were comparable for the two groups. After adjustment, the factors associated with adverse perinatal outcomes were primiparity and birth weight <2500 g.
CONCLUSIONS: Routine maneuvers were not associated with an increase in neonatal morbidity in our population.
METHODS: This was a secondary analysis of the multicenter PREMODA observational prospective study in France and Belgium. We included women with vaginal breech delivery, excluding those who underwent maneuvers to resolve a dystocic delivery. Maternal data and characteristics of labor, in addition to neonatal and maternal outcomes, were recorded. We defined two groups according to mode of delivery; breech vaginal delivery with or without routine maneuvers, and we compared the variables between the groups. To assess the factors associated with adverse perinatal outcomes, a multivariate logistic regression with adjustment for confounders was performed.
RESULTS: Of the 2502 women with planned vaginal deliveries, 1794 were delivered vaginally, 606 of whom were excluded from the study due to maneuvers performed for dystocia. A total of 25 other patients were excluded as a result of missing data. A total of 537 women were included in the routine maneuvers group and 626 women in the no maneuvers group. Adverse perinatal outcome was similar for the two groups (4.5% vs 5.0%, P = 0.65) and no neonatal deaths were reported. Third degree perineal tear and postpartum hemorrhage >1 L rates were comparable for the two groups. After adjustment, the factors associated with adverse perinatal outcomes were primiparity and birth weight <2500 g.
CONCLUSIONS: Routine maneuvers were not associated with an increase in neonatal morbidity in our population.
摘要：
目的：研究足月臀位阴道分娩与常规操作相关的新生儿和产妇结局。
方法：这是法国和比利时的多中心PREMODA观察性前瞻性研究的二次分析。我们包括阴道臀位分娩的女性，不包括那些为解决分娩困难而进行机动的人。产妇数据和分娩特征，除了新生儿和产妇的结局，被记录下来。我们根据分娩方式定义了两组；臀位阴道分娩有或没有常规操作，我们比较了各组之间的变量。评估与不良围产期结局相关的因素，我们进行了校正混杂因素的多变量逻辑回归.
结果：在计划阴道分娩的2502名妇女中，1794年阴道分娩，其中606人因难产而被排除在研究之外。由于数据缺失，总共排除了25名其他患者。常规演习组共有537名妇女，无演习组共有626名妇女。两组的不良围产期结局相似（4.5％vs5.0％，P=0.65），无新生儿死亡报告。两组的会阴三度撕裂和产后出血>1L的发生率具有可比性。调整后,与不良围产期结局相关的因素是初产和出生体重<2500g.
结论：常规操作与我们人群中新生儿发病率的增加无关。
方法：这是法国和比利时的多中心PREMODA观察性前瞻性研究的二次分析。我们包括阴道臀位分娩的女性，不包括那些为解决分娩困难而进行机动的人。产妇数据和分娩特征，除了新生儿和产妇的结局，被记录下来。我们根据分娩方式定义了两组；臀位阴道分娩有或没有常规操作，我们比较了各组之间的变量。评估与不良围产期结局相关的因素，我们进行了校正混杂因素的多变量逻辑回归.
结果：在计划阴道分娩的2502名妇女中，1794年阴道分娩，其中606人因难产而被排除在研究之外。由于数据缺失，总共排除了25名其他患者。常规演习组共有537名妇女，无演习组共有626名妇女。两组的不良围产期结局相似（4.5％vs5.0％，P=0.65），无新生儿死亡报告。两组的会阴三度撕裂和产后出血>1L的发生率具有可比性。调整后,与不良围产期结局相关的因素是初产和出生体重<2500g.
结论：常规操作与我们人群中新生儿发病率的增加无关。
