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Tresch C, Lallemant M, Nallet C, Offringa Y, Ramanah R, Guerby P, Mottet N. Updating of pelvimetry standards in modern obstetrics. Sci Rep 2024; 14:3080. [PMID: 38321054 PMCID: PMC10847410 DOI: 10.1038/s41598-024-53603-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/02/2024] [Indexed: 02/08/2024] Open
Abstract
Clinical value of pelvimetry in modern obstetrics practices has never been established and normal values are set since the middle of the twentieth century. The aim of this study was to describe current dimensions of pelvis in a female French Caucasian population. A retrospective, bi-centric observational study was conducted from August 2013 to August 2019 in two French departments of Obstetrics. We included all Caucasian women who had a computed tomography pelvimetry during pregnancy. The primary outcome was the values of the obstetric transverse diameter, obstetric conjugate diameter and bispinous diameter. Five hundred and fifty-one CT pelvimetries were analyzed. The median Obstetric Transverse Diameter (OTD) was 12.41 cm and the 3rd percentile was 11 cm. The median Obstetric Conjugate Diameter (OCD) was 12.2 cm and the 3rd percentile was 10.5 cm. The median Bispinous Diameter (BSD) in our data collection was 10.9 cm and the 3rd percentile was 9.3 cm. A significant correlation coefficient between women's height and OTD, OCD and BSD was found. In our study, the OCD and the BSD have not evolved since the middle of the twentieth century. The obstetric transverse diameter was smaller than the standard currently used.
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Affiliation(s)
- Caroline Tresch
- Department of Obstetrics and Gynecology, Besancon University Medical Centre, University of Franche-Comté, Besancon, France.
| | - Marine Lallemant
- Department of Obstetrics and Gynecology, Besancon University Medical Centre, University of Franche-Comté, Besancon, France
| | - Camille Nallet
- Department of Obstetrics and Gynecology, Besancon University Medical Centre, University of Franche-Comté, Besancon, France
| | - Yvonne Offringa
- Department of Obstetrics and Gynecology, Paule de Viguier University Medical Centre, Toulouse III University, Toulouse, France
| | - Rajeev Ramanah
- Department of Obstetrics and Gynecology, Besancon University Medical Centre, University of Franche-Comté, Besancon, France
| | - Paul Guerby
- Department of Obstetrics and Gynecology, Paule de Viguier University Medical Centre, Toulouse III University, Toulouse, France
| | - Nicolas Mottet
- Department of Obstetrics and Gynecology, Besancon University Medical Centre, University of Franche-Comté, Besancon, France
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Libretti A, Surico D, Corsini C, Aquino CI, Fracon S, Remorgida V. YouTube™ as a Source of Information on Acupuncture for Correction of Breech Presentation. Cureus 2023; 15:e35182. [PMID: 36960249 PMCID: PMC10029830 DOI: 10.7759/cureus.35182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND AND AIM Breech presentation is a condition that occurs in rare cases in pregnancy. Although guidelines recommend a cesarian section or an external cephalic version in case of breech, alternative procedures like acupuncture, are also available. Information on this approach is mostly found by patients through social media; we aimed to study content quality and the reliability of information present on YouTube™ (Google LLC, Mountain View, California, United States), one of the most popular. METHODS Two gynecologists and an anesthesiologist, who was qualified as an acupuncturist, rated the reliability and the content quality of 23 of the first 100 results from YouTube. Normal data distribution was tested with the Shapiro-Wilk test. General features of videos, reliability, and content quality were compared with the Wilcoxon-Mann-Whitney test (continuous variables) and the Chi-square test (categorical variables). All tests were two-sided, and the statistical significance level was determined at p<0.05. RESULTS Concerning reliability, all videos were rated poorly while only one was judged as sufficiently high in quality content. Lower scores in terms of reliability and content quality resulted from the reviewers' evaluation with no videos reported as suggestable to patients. Two videos were considered fit to be suggested to patients by the gynecologist reviewers. CONCLUSIONS Information about the role and the success rate of acupuncture for converting breech presentation found on YouTube are poorly reliable, low-quality, and not valid for patients. It should be a physician's duty to provide correct information to patients.
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Affiliation(s)
- Alessandro Libretti
- Obstetrics and Gynaecology, University Hospital Maggiore della Carità, Novara, ITA
| | - Daniela Surico
- Obstetrics and Gynaecology, University Hospital Maggiore della Carità, Novara, ITA
| | - Christian Corsini
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, Istituto di Ricovero e Cura a Carattere Scientifico, San Raffaele University Hospital, Milan, ITA
| | - Carmen Imma Aquino
- Obstetrics and Gynaecology, University Hospital Maggiore della Carità, Novara, ITA
| | - Sara Fracon
- Anesthesia and Critical Care, University Hospital Maggiore della Carità, Novara, ITA
| | - Valentino Remorgida
- Obstetrics and Gynaecology, University Hospital Maggiore della Carità, Novara, ITA
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Le Bars S, Harendarczyk L, Mortier A, Riche VP, Arthuis C, Thubert T, Winer N, Dochez V. [Tocolysis during External Cephalic Version (ECV): A retrospective before/after study in a type III maternity hospital]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:585-590. [PMID: 35644371 DOI: 10.1016/j.gofs.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE On January 2020, the French College of Gynecologists and Obstetricians (CNGOF) issued new Clinical Practice Guidelines (CPG) "Breech Presentation". Since then, it is recommended to use a tocolytic agent to improve the success rate of External Cephalic Version (ECV). The aim of this study, one year after these CPG, is to compare ECV without (before CPG) and with (after CPG) tocolysis in a type III maternity hospital. We intend to assess its effects on immediate success rate of ECV and obstetrical and neonatal outcomes. MATERIALS AND METHODS This is a single-center retrospective study conducted in Nantes University Hospital. We collected patient characteristics, immediate success rate, and maternal and neonatal outcomes at delivery of all ECV over two periods: the first one during 2019 (before CPG) and the second one from June 2020 to June 2021 (after CPG). RESULTS We included 253 patients: 126 in the first period and 127 in the second period. Immediate success rate of ECV was significantly higher since the use of tocolysis: 38.6 % (period 2) vs 23.8 % (period 1) (P=0.011). However, there was not significant difference found for cephalic presentation at birth, mode of delivery or obstetrical and neonatal outcomes. CONCLUSION The immediate success rate is significantly improved with the widespread use of tocolysis during ECV, with no change in obstetrical and neonatal outcomes.
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Affiliation(s)
- S Le Bars
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France
| | - L Harendarczyk
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France
| | - A Mortier
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France
| | - V-P Riche
- Service evaluation economique et développement des produits de santé, département partenariats et innovation, direction de la recherche, CHU de Nantes, Nantes, France
| | - C Arthuis
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France; Centre d'investigation clinique CIC 1413, INSERM, CHU de Nantes, Nantes, France
| | - T Thubert
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France; Centre d'investigation clinique CIC 1413, INSERM, CHU de Nantes, Nantes, France; Nantes université, mouvement - interactions-performance - MIP, EA4334, Nantes, France
| | - N Winer
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France; Centre d'investigation clinique CIC 1413, INSERM, CHU de Nantes, Nantes, France
| | - V Dochez
- Service de gynécologie-obstétrique, CHU de Nantes, Nantes, France; Centre d'investigation clinique CIC 1413, INSERM, CHU de Nantes, Nantes, France; Nantes université, mouvement - interactions-performance - MIP, EA4334, Nantes, France.
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Toijonen A, Heinonen S, Gissler M, Macharey G. Neonatal outcome in vaginal breech labor at 32 + 0-36 + 0 weeks of gestation: a nationwide, population-based record linkage study. BMC Pregnancy Childbirth 2022; 22:211. [PMID: 35296277 PMCID: PMC8928595 DOI: 10.1186/s12884-022-04547-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background In many countries, vaginal breech labor at term is an option in selected cases. However, the safety of vaginal breech labor in preterm is still unclear. Therefore our study aimed to evaluate the safety of vaginal breech labor in late preterm deliveries. Design A retrospective register-based study. Setting Maternity hospitals in Finland, 2004–2017. Participants The study population included 762 preterm breech deliveries at 32 + 0—36 + 6 gestational weeks according to the mode of delivery, 535 (70.2%) of them were born vaginally in breech presentation, and 227 (29.8%) were delivered by non-urgent cesarean section. Methods The study compared short-term neonatal adverse outcomes of singleton vaginal breech deliveries with non-urgent cesarean deliveries at 32 + 0 to 36 + 6 weeks of gestation. An odd ratio with 95% confidence intervals was calculated to estimate the relative risk of adverse outcomes. Outcome measures Neonatal death, an arterial umbilical pH below seven, a five-minute Apgar score below four and seven, admission to neonatal intensive care unit, neonatal intubation, neonatal antibiotic therapy, neonatal birth trauma, respiratory distress syndrome, neonatal convulsions, cerebral ischemia, hypoxic-ischemic encephalopathy, congenital hypotonia, and a composite of severe adverse outcomes. Results A five-minute Apgar scores below seven were increased in vaginal breech labor at 32 + 0 to 36 + 6 weeks of gestation compared to non-urgent cesarean sections (aOR 2.48, 95% CI 1.08–5.59). Neonatal antibiotic therapy, the admission to neonatal intensive care unit, and neonatal respiratory distress syndrome were decreased after vaginal breech labor compared to the outcomes of non-urgent cesarean section (neonatal antibiotic therapy aOR 0.60, 95% CI 0.40–0.89; neonatal NICU admission aOR 0.47, 95% CI 0.33–0.68; respiratory distress syndrome aOR 0.30, 95% CI 0.19–0.48). Conclusion Vaginal breech labor at 32 + 0—36 + 6 gestational weeks does not increase severe neonatal short-term morbidity or mortality compared to cesarean section.
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Affiliation(s)
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, University Hospital (HUS), University of Helsinki, Haartmaninkatu 2, 00290, Helsinki, Finland
| | - Mika Gissler
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Georg Macharey
- Department of Obstetrics and Gynecology, University Hospital (HUS), University of Helsinki, Haartmaninkatu 2, 00290, Helsinki, Finland
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Toijonen A, Heinonen S, Gissler M, Seikku L, Macharey G. Impact of fetal presentation on neurodevelopmental outcome in a trial of preterm vaginal delivery: a nationwide, population-based record linkage study. Arch Gynecol Obstet 2021; 306:29-35. [PMID: 34718843 PMCID: PMC9300511 DOI: 10.1007/s00404-021-06146-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the risk of adverse neurodevelopmental outcomes at the age of four after an attempted vaginal delivery according to the fetal presentation in birth. METHODS This retrospective record linkage study evaluated the risks of cerebral palsy, epilepsy, intellectual disability, autism spectrum disorder, attention-deficit/hyperactivity disorder, and speech, visual, and auditory disabilities among preterm children born after an attempted vaginal breech delivery. The control group comprised children born in a cephalic presentation at the same gestational age. This study included 23 803 singleton deliveries at gestational weeks 24 + 0-36 + 6 between 2004 and 2014. RESULTS From 1629 women that underwent a trial of vaginal breech delivery, 1122 (66.3%) were converted to emergency cesarean sections. At extremely preterm and very preterm gestations (weeks 24 + 0-31 + 6), no association between a trial of vaginal breech delivery and neurodevelopmental delay occurred. At gestational weeks 32 + 0-36 + 6, the risks of visual disability (aOR 1.67, CI 1.07-2.60) and autism spectrum disorders (aOR 2.28, CI 1.14-4.56) were increased after an attempted vaginal breech delivery as compared to vaginal cephalic delivery. CONCLUSION A trial of vaginal breech delivery at extremely preterm and very preterm gestations appears not to increase the risk of adverse neurodevelopmental outcomes at the age of four. In moderate to late preterm births, a trial of vaginal breech delivery was associated with an increased risk of visual impairment and autism spectrum disorders compared to children born in cephalic presentation. A trial of vaginal preterm breech delivery requires distinctive consideration and careful patient selection.
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Affiliation(s)
- Anna Toijonen
- Department of Obstetrics and Gynecology, University of Helsinki, Riihiuunintie 12 c, 02620 Espoo, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, University Hospital (HUS), University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland
| | - Mika Gissler
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Laura Seikku
- Department of Obstetrics and Gynecology, University Hospital (HUS), University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland
| | - Georg Macharey
- Department of Obstetrics and Gynecology, University Hospital (HUS), University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland
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Macharey G, Gissler M, Toijonen A, Heinonen S, Seikku L. Congenital anomalies in breech presentation: A nationwide record linkage study. Congenit Anom (Kyoto) 2021; 61:112-117. [PMID: 33559256 DOI: 10.1111/cga.12411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/11/2021] [Accepted: 02/02/2021] [Indexed: 01/21/2023]
Abstract
Our study aimed to determine if congenital anomalies are associated with breech presentation at delivery. We conducted a nationwide, retrospective population-based record linkage study and analyzed all singleton births in Finland from 1996 to 2016 using the mandatory health register data collected by the Finnish Institute for Health and Welfare. We compared all major congenital anomalies detected during pregnancy, birth, or the first year of life according to the fetus's presentation at the time of delivery using X2 -square statistic and Student's t test. We adjusted the results for known risk factors for congenital anomalies to estimate adjusted odds ratios and 95% confidence intervals. Fetuses in breech presentation at delivery had an increased risk for congenital anomalies (6.5%) compared with fetuses in cephalic presentation (3.6%), P < .001. Breech presentation was associated with nearly all types of examined congenital anomalies. The strongest associations were observed with congenital deformities of the hip, the central nervous system, the respiratory system, and the musculoskeletal system. Our study supports the theory that breech presentation is, in many cases, a symptom of a fundamental problem in fetal morphogenesis or function. Neonates born in the breech presentation have a higher risk of congenital anomalies and should undergo a postnatal screening.
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Affiliation(s)
- Georg Macharey
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Mika Gissler
- Information Services Department, Finnish Institute for Health and Welfare (THL), Helsinki, Finland and Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden
| | - Anna Toijonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura Seikku
- Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Fagard J, De Agostini M, Huet V, Granjon L, Heude B. Is Handedness at Five Associated with Prenatal Factors? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3529. [PMID: 33805348 PMCID: PMC8037573 DOI: 10.3390/ijerph18073529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/19/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022]
Abstract
The goal of the study was to investigate some of the factors suspected to be related to children's handedness: presentation during the last weeks of gestation and at birth (cephalic or breech), side of presentation (right or left), number of weeks of gestation, season of birth, parents' handedness and sex. We analyzed the relationships between these factors and the child's handedness at five years. Children (n = 1897) from the EDEN cohort participated in the study, among which 1129 were tested for handedness at five. The father's handedness, but not the mother's, was significantly related to the child's hand preference. The percentage of left-handed children was significantly larger when the father was non-right-handed compared to right-handed, and tended to be larger among children in non-left-cephalic presentation compared to left-cephalic presentation. Girls, but not boys, were significantly less lateralized when they were born before 37 weeks of pregnancy than after. Finally, children born in winter or spring were slightly but significantly less lateralized than children born in summer or autumn. All six children who were not lateralized at 5 presented one or several of these factors. These results are discussed in light of the mixed model of handedness.
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Affiliation(s)
- Jacqueline Fagard
- Université de Paris, INCC UMR 8002, CNRS, F-75006 Paris, France; (V.H.); (L.G.)
| | - Maria De Agostini
- Centre for Research in Epidemiology and Statistics (CRESS), Université de Paris, INSERM, INRAE, F-75004 Paris, France; (M.D.A.); (B.H.)
| | - Viviane Huet
- Université de Paris, INCC UMR 8002, CNRS, F-75006 Paris, France; (V.H.); (L.G.)
| | - Lionel Granjon
- Université de Paris, INCC UMR 8002, CNRS, F-75006 Paris, France; (V.H.); (L.G.)
| | - Barbara Heude
- Centre for Research in Epidemiology and Statistics (CRESS), Université de Paris, INSERM, INRAE, F-75004 Paris, France; (M.D.A.); (B.H.)
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