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Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo)

Received: 26 February 2022     Accepted: 14 March 2022     Published: 18 March 2022
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Abstract

Objective. To analyze the determinants of the delivery route and the neonatal prognosis in case of breech presentation at the University Hospital Center of Brazzaville. Method. Monocentric analytical cross-sectional study conducted from January 1 to December 31, 2019 in the Obstetrics Gynecology Department of the University Hospital Center of Brazzaville, comparing 54 women who gave birth by cesarean section and 23 women who gave birth vaginally. Were included all women who gave birth to a fetus in breech presentation whose chronological age was greater than or equal to 28 weeks of amenorrhea or a birth weight greater than 1000 g and their newborn. The variables studied were pre, per and post partal. The p-value of the probability was considered significant for a value less than 0.05. Results. Breech delivery represented 1.6% of deliveries, i.e. 97 out of 6075. The women delivered were not different in age [29 (24-34) vs 29 (26-33), p>0.05] nor in parity [1 (0-3) vs 2 (0-3), p>0.05]. Most of them gave birth by caesarean section (63.9% vs 36.1%). The determinants of the delivery route were: level of education (48.1% vs 73.9%; OR=3.1 [1.04-8.9]; p<0.05), gestational age less than 34 WA (0% vs 13%; p<0.05), the existence of a uterine scar (22.2% vs 0%; p<0.05) and insufficient fundal height (3.7% vs 26.1%; OR=0.12 [0.02 – 0.7]; p<0.05). Neonatal morbidity was not influenced by the route of delivery. Newborns from the vaginal route were the most transferred to neonatology (5.6% vs 34.8%; OR=0.11 [0.3 – 0.47]; p<0.05) and died (0% vs. 17.4%; p<0.05). Conclusion. The decision of the way of delivery in case of breech presentation at the University Hospital of Brazzaville depends on both maternal and obstetrical factors. Identifying the determinants requires careful questioning and rigorous obstetrical examination.

Published in Journal of Gynecology and Obstetrics (Volume 10, Issue 2)
DOI 10.11648/j.jgo.20221002.16
Page(s) 92-96
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Breech Presentation, Childbirth, Determinants, Prognosis, Congo

References
[1] Merger R, Lévy J, Melchior J. editors. Precis of Obstetrics. 6th edition. Paris: Elsevier Masson SAS. Mason, 185-200. 2011.
[2] National College of French Obstetrician Gynecologists (CNGOF). Protocols in Obstetrics Gynecology. 4th edition. Paris: Elsevier Masson SAS. Masson, 262-64.2018.
[3] Buambo Bamanga SF, Makoumbou P, Oyere-Moke P, Gnekoumou A, Nkihouabonga G, Gokana H et al. Delivery in Breech Presentation at the University Hospital of Brazzaville. Med Afr Noire 2006; 53 (5): 287-92.
[4] Robert M, Jean L, Jean M. Summary of Obstetrics. 6th edition. Paris: Masson, 618. 1995.
[5] Hannah ME, Hannah WJ, Hewson SA, Hodnett ED, Saigal SA. Planned Caesarean Section versus Planned Vaginal Birth for Breech Presentation at Term: a Randomized Multicented Trial. The Lancet 2000; 356 (9239): 1375-83.
[6] College National des Gynecologues Obstetriciens Français (CNGOF). Clinical Practice Guidelines (CPR) for Breech Presentation. J Gynecol Obstet Biol Reprod 2001, 30: 191-2.
[7] Sentilhes L, Schmitz T, Azria E, Gallot D, Ducarme G, Korb D et al. Presentation of the Seat. CNGOF Clinical Practice Guidelines. Gynecol Obstet Fertil Senol 2020; 48: 63-9.
[8] Lagrange E, Ab der Halden M, Ughetto S, Boda C, Accoceberry M, Neyrat C et al. Vaginal Breech Birth: Evolution of Acceptability by Obstetricians and Patients. Gynecol Obstet Fertil 2007; 35: 757-63.
[9] Mayi-Tsonga S, Mandji J, Mimbila Mayi M, Sima Ole B, Bang J, Meye J. Prognosis of Breech Delivery at Term: Comparative and Analytical Study in Libreville (Gabon). Clin Mother Child Health 2012; 9. Article ID C120602, 5 p. Doi: 10.4303/cmch/C120602.
[10] Nayama M, Diori Salifou M, Soumana H et al. Delivery in Breech Presentation. Perinatal and Maternal Prognosis in a Reference Maternity Hospital in Niger. Retrospective Study about 317 cases. Med Afr Noire 2008, 55 (7): 417-24.
[11] American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 340. Mode of Term Singleton Breech Delivery. Obstet Gynecol 2006; 108: 235-7.
[12] Faye Dieme M. E, Gassama OG, Diadhiou MT et al. Management of Delivery in Breech Presentation at the Nabil Choucair Health Center in Dakar (Senegal). SAGO Journal 2018; 19 (2): 16-22.
[13] Ulander N. M., Gissler M., Nutila M., Ylikorkala O. Are Health Expectations of Term Breech Infants Unrealistically High? PubMed. Acta obst Gynecol Scand. 2004; 83 (2): 180-6.
[14] White H, Hannah M, Saigal S, and al. Outcomes of Children at 2 Years After Planned Cesarean Birth versus Planned Vaginal Birth for Breech Presentation at Term the International Randomized Term Breech Trial. Am J Obst Gynecol 2004; 191: 864-71.
[15] Carayol M., Goffinet F. Mode of Delivery of Women with Breech Presentation at Term in the PREMODA Study (Presentation and Mode of Delivery). J Gynecol Obstet Biol Reprod 2004; 33 (1): 34-44.
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  • APA Style

    Buambo Gauthier Regis Jostin, Eouani Levy Max Emery, Ngami Ariane Glore, Mokoko Jules Cesar, Potokoue Mpia Sekangue Samantha Nuelly, et al. (2022). Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo). Journal of Gynecology and Obstetrics, 10(2), 92-96. https://doi.org/10.11648/j.jgo.20221002.16

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    ACS Style

    Buambo Gauthier Regis Jostin; Eouani Levy Max Emery; Ngami Ariane Glore; Mokoko Jules Cesar; Potokoue Mpia Sekangue Samantha Nuelly, et al. Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo). J. Gynecol. Obstet. 2022, 10(2), 92-96. doi: 10.11648/j.jgo.20221002.16

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    AMA Style

    Buambo Gauthier Regis Jostin, Eouani Levy Max Emery, Ngami Ariane Glore, Mokoko Jules Cesar, Potokoue Mpia Sekangue Samantha Nuelly, et al. Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo). J Gynecol Obstet. 2022;10(2):92-96. doi: 10.11648/j.jgo.20221002.16

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  • @article{10.11648/j.jgo.20221002.16,
      author = {Buambo Gauthier Regis Jostin and Eouani Levy Max Emery and Ngami Ariane Glore and Mokoko Jules Cesar and Potokoue Mpia Sekangue Samantha Nuelly and Itoua Clautaire and Iloki Leon Herve},
      title = {Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo)},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {10},
      number = {2},
      pages = {92-96},
      doi = {10.11648/j.jgo.20221002.16},
      url = {https://doi.org/10.11648/j.jgo.20221002.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20221002.16},
      abstract = {Objective. To analyze the determinants of the delivery route and the neonatal prognosis in case of breech presentation at the University Hospital Center of Brazzaville. Method. Monocentric analytical cross-sectional study conducted from January 1 to December 31, 2019 in the Obstetrics Gynecology Department of the University Hospital Center of Brazzaville, comparing 54 women who gave birth by cesarean section and 23 women who gave birth vaginally. Were included all women who gave birth to a fetus in breech presentation whose chronological age was greater than or equal to 28 weeks of amenorrhea or a birth weight greater than 1000 g and their newborn. The variables studied were pre, per and post partal. The p-value of the probability was considered significant for a value less than 0.05. Results. Breech delivery represented 1.6% of deliveries, i.e. 97 out of 6075. The women delivered were not different in age [29 (24-34) vs 29 (26-33), p>0.05] nor in parity [1 (0-3) vs 2 (0-3), p>0.05]. Most of them gave birth by caesarean section (63.9% vs 36.1%). The determinants of the delivery route were: level of education (48.1% vs 73.9%; OR=3.1 [1.04-8.9]; p<0.05), gestational age less than 34 WA (0% vs 13%; p<0.05), the existence of a uterine scar (22.2% vs 0%; p<0.05) and insufficient fundal height (3.7% vs 26.1%; OR=0.12 [0.02 – 0.7]; p<0.05). Neonatal morbidity was not influenced by the route of delivery. Newborns from the vaginal route were the most transferred to neonatology (5.6% vs 34.8%; OR=0.11 [0.3 – 0.47]; p<0.05) and died (0% vs. 17.4%; p<0.05). Conclusion. The decision of the way of delivery in case of breech presentation at the University Hospital of Brazzaville depends on both maternal and obstetrical factors. Identifying the determinants requires careful questioning and rigorous obstetrical examination.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - Breech Presentation: Determinants of the Delivery Route and Neonatal Prognosis at the University Hospital Center of Brazzaville (Republic of Congo)
    AU  - Buambo Gauthier Regis Jostin
    AU  - Eouani Levy Max Emery
    AU  - Ngami Ariane Glore
    AU  - Mokoko Jules Cesar
    AU  - Potokoue Mpia Sekangue Samantha Nuelly
    AU  - Itoua Clautaire
    AU  - Iloki Leon Herve
    Y1  - 2022/03/18
    PY  - 2022
    N1  - https://doi.org/10.11648/j.jgo.20221002.16
    DO  - 10.11648/j.jgo.20221002.16
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 92
    EP  - 96
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20221002.16
    AB  - Objective. To analyze the determinants of the delivery route and the neonatal prognosis in case of breech presentation at the University Hospital Center of Brazzaville. Method. Monocentric analytical cross-sectional study conducted from January 1 to December 31, 2019 in the Obstetrics Gynecology Department of the University Hospital Center of Brazzaville, comparing 54 women who gave birth by cesarean section and 23 women who gave birth vaginally. Were included all women who gave birth to a fetus in breech presentation whose chronological age was greater than or equal to 28 weeks of amenorrhea or a birth weight greater than 1000 g and their newborn. The variables studied were pre, per and post partal. The p-value of the probability was considered significant for a value less than 0.05. Results. Breech delivery represented 1.6% of deliveries, i.e. 97 out of 6075. The women delivered were not different in age [29 (24-34) vs 29 (26-33), p>0.05] nor in parity [1 (0-3) vs 2 (0-3), p>0.05]. Most of them gave birth by caesarean section (63.9% vs 36.1%). The determinants of the delivery route were: level of education (48.1% vs 73.9%; OR=3.1 [1.04-8.9]; p<0.05), gestational age less than 34 WA (0% vs 13%; p<0.05), the existence of a uterine scar (22.2% vs 0%; p<0.05) and insufficient fundal height (3.7% vs 26.1%; OR=0.12 [0.02 – 0.7]; p<0.05). Neonatal morbidity was not influenced by the route of delivery. Newborns from the vaginal route were the most transferred to neonatology (5.6% vs 34.8%; OR=0.11 [0.3 – 0.47]; p<0.05) and died (0% vs. 17.4%; p<0.05). Conclusion. The decision of the way of delivery in case of breech presentation at the University Hospital of Brazzaville depends on both maternal and obstetrical factors. Identifying the determinants requires careful questioning and rigorous obstetrical examination.
    VL  - 10
    IS  - 2
    ER  - 

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Author Information
  • Obstetrics Gynecology Department, University Hospital Center of Brazzaville, Brazzaville, Congo

  • Obstetrics Gynecology Department, Loandjili General Hospital, Pointe Noire, Congo

  • Obstetrics Gynecology Department, University Hospital Center of Brazzaville, Brazzaville, Congo

  • Obstetrics Gynecology Department, University Hospital Center of Brazzaville, Brazzaville, Congo

  • Obstetrics Gynecology Department, University Hospital Center of Brazzaville, Brazzaville, Congo

  • Obstetrics Gynecology Department, University Hospital Center of Brazzaville, Brazzaville, Congo

  • Obstetrics Gynecology Department, University Hospital Center of Brazzaville, Brazzaville, Congo

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