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

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Practical insight into upright breech birth from birth videos : A structured analysis. / Reitter, Anke; Halliday, Alexandra; Walker, Shawn.

In: Birth, Vol. 47, No. 2, 01.06.2020, p. 211-219.

Research output: Contribution to journalArticle

Harvard

Reitter, A, Halliday, A & Walker, S 2020, 'Practical insight into upright breech birth from birth videos: A structured analysis', Birth, vol. 47, no. 2, pp. 211-219. https://doi.org/10.1111/birt.12480

APA

Reitter, A., Halliday, A., & Walker, S. (2020). Practical insight into upright breech birth from birth videos: A structured analysis. Birth, 47(2), 211-219. https://doi.org/10.1111/birt.12480

Vancouver

Reitter A, Halliday A, Walker S. Practical insight into upright breech birth from birth videos: A structured analysis. Birth. 2020 Jun 1;47(2):211-219. https://doi.org/10.1111/birt.12480

Author

Reitter, Anke ; Halliday, Alexandra ; Walker, Shawn. / Practical insight into upright breech birth from birth videos : A structured analysis. In: Birth. 2020 ; Vol. 47, No. 2. pp. 211-219.

Bibtex Download

@article{4c7f085c821b4bffba85356fd4cde467,
title = "Practical insight into upright breech birth from birth videos: A structured analysis",
abstract = "Background: We aimed to identify common features of upright vaginal breech births with good outcomes to refine a physiological approach to teaching breech birth. Methods: We performed a structured analysis of 42 videos of successful upright breech births (eg, kneeling, hand/knees), facilitated by obstetricians (n = 34) and midwives (n = 8) in nine different countries. Precise timings and relevant clinical details were recorded on an Excel spreadsheet. Each video was analyzed twice by at least two members of the research team. Time-to-event intervals, frequencies of interventions, and descriptive statistics were calculated using SPSS. Results: A completely spontaneous (labor mechanisms and maternal effort only) birth occurred in 14/42 (33%) cases. The median time between the birth of the fetal pelvis and the head in all births was 1:52 (IQR 1:05,2:46; min:sec). Lack of spontaneous rotation to a sacro-anterior position by the time the fetus had emerged to the nipple line was strongly associated with fetal arm entrapment. The following maneuvers were used: shoulder press to flex the aftercoming head in midpelvis or outlet (n = 24), sweeping down arm/s (n = 12), buttock lift to assist shoulder press (n = 6), modified Mauriceau (n = 6), rotational maneuvers to release an entrapped arm (n = 6), elevate and rotate fetal head to assist engagement (n = 2), and conversion into supine maternal position (n = 2). Conclusions: Most upright breech births occur within 3 minutes of the birth of the fetal pelvis. Upright breech birth attendants use variations of traditional maneuvers. We introduce a physiological breech algorithm as an initial timekeeping framework for teaching, research, and practice.",
keywords = "algorithm, birth videos, breech presentation, intrapartum care, mechanisms",
author = "Anke Reitter and Alexandra Halliday and Shawn Walker",
year = "2020",
month = jun,
day = "1",
doi = "10.1111/birt.12480",
language = "English",
volume = "47",
pages = "211--219",
journal = "Birth (Berkeley, Calif.)",
issn = "0730-7659",
number = "2",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Practical insight into upright breech birth from birth videos

T2 - A structured analysis

AU - Reitter, Anke

AU - Halliday, Alexandra

AU - Walker, Shawn

PY - 2020/6/1

Y1 - 2020/6/1

N2 - Background: We aimed to identify common features of upright vaginal breech births with good outcomes to refine a physiological approach to teaching breech birth. Methods: We performed a structured analysis of 42 videos of successful upright breech births (eg, kneeling, hand/knees), facilitated by obstetricians (n = 34) and midwives (n = 8) in nine different countries. Precise timings and relevant clinical details were recorded on an Excel spreadsheet. Each video was analyzed twice by at least two members of the research team. Time-to-event intervals, frequencies of interventions, and descriptive statistics were calculated using SPSS. Results: A completely spontaneous (labor mechanisms and maternal effort only) birth occurred in 14/42 (33%) cases. The median time between the birth of the fetal pelvis and the head in all births was 1:52 (IQR 1:05,2:46; min:sec). Lack of spontaneous rotation to a sacro-anterior position by the time the fetus had emerged to the nipple line was strongly associated with fetal arm entrapment. The following maneuvers were used: shoulder press to flex the aftercoming head in midpelvis or outlet (n = 24), sweeping down arm/s (n = 12), buttock lift to assist shoulder press (n = 6), modified Mauriceau (n = 6), rotational maneuvers to release an entrapped arm (n = 6), elevate and rotate fetal head to assist engagement (n = 2), and conversion into supine maternal position (n = 2). Conclusions: Most upright breech births occur within 3 minutes of the birth of the fetal pelvis. Upright breech birth attendants use variations of traditional maneuvers. We introduce a physiological breech algorithm as an initial timekeeping framework for teaching, research, and practice.

AB - Background: We aimed to identify common features of upright vaginal breech births with good outcomes to refine a physiological approach to teaching breech birth. Methods: We performed a structured analysis of 42 videos of successful upright breech births (eg, kneeling, hand/knees), facilitated by obstetricians (n = 34) and midwives (n = 8) in nine different countries. Precise timings and relevant clinical details were recorded on an Excel spreadsheet. Each video was analyzed twice by at least two members of the research team. Time-to-event intervals, frequencies of interventions, and descriptive statistics were calculated using SPSS. Results: A completely spontaneous (labor mechanisms and maternal effort only) birth occurred in 14/42 (33%) cases. The median time between the birth of the fetal pelvis and the head in all births was 1:52 (IQR 1:05,2:46; min:sec). Lack of spontaneous rotation to a sacro-anterior position by the time the fetus had emerged to the nipple line was strongly associated with fetal arm entrapment. The following maneuvers were used: shoulder press to flex the aftercoming head in midpelvis or outlet (n = 24), sweeping down arm/s (n = 12), buttock lift to assist shoulder press (n = 6), modified Mauriceau (n = 6), rotational maneuvers to release an entrapped arm (n = 6), elevate and rotate fetal head to assist engagement (n = 2), and conversion into supine maternal position (n = 2). Conclusions: Most upright breech births occur within 3 minutes of the birth of the fetal pelvis. Upright breech birth attendants use variations of traditional maneuvers. We introduce a physiological breech algorithm as an initial timekeeping framework for teaching, research, and practice.

KW - algorithm

KW - birth videos

KW - breech presentation

KW - intrapartum care

KW - mechanisms

UR - http://www.scopus.com/inward/record.url?scp=85078668866&partnerID=8YFLogxK

U2 - 10.1111/birt.12480

DO - 10.1111/birt.12480

M3 - Article

AN - SCOPUS:85078668866

VL - 47

SP - 211

EP - 219

JO - Birth (Berkeley, Calif.)

JF - Birth (Berkeley, Calif.)

SN - 0730-7659

IS - 2

ER -

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