Uterine Activity in Spontaneous Labour with Breech Presentation

S. Arulkumaran, I. Ingemarsson, D. M.F. Gibb, S. S. Ratnam

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

EDITORIAL COMMENT: In this unusual and interesting study the authors found that uterine activity in patients with breech presentation is similar to that in patients with vertex presentations, when controlled for parity (nulliparas versus multiparas). The study did not consider the type of breech presentation, although one might expect labour to be more coordinate and effective with a breech with extended legs than with a complete breech. It is interesting to note that the authors practise amniotomy in the active phase of labour when the breech presents ‘provided that cord presentation or a high presenting part is excluded’. In this group of patients the authors did not employ either epidural analgesia or oxytocin enhancement of labour. The authors make the point that normal uterine activity in patients with breech presentation does not guarantee safe breech delivery. Readers should note that in this series criteria for inclusion included normal pelvic and fetal dimensions, and spontaneous onset of labour. Summary: Uterine activity was quantified for patients who had a breech presentation, spontaneous labour and a vaginal delivery. Results were studied according to parity and in relation to cervical dilatation. The multiparas with breech presentation overall had lower uterine activity compared to nulliparas when the whole labour was considered. These values were compared with control patients with vertex presentation who had spontaneous normal labour and vaginal delivery. The median uterine activity values in breech presentation were not significantly different from control nulliparous or multiparous patients. Among the breech deliveries, irrespective of parity, mean Apgar scores at 1 and 5 minutes were over 6 and cord arterial blood pH values were above 7.15, but these results were significantly lower than the contol cases with vertex presentation. The uterus performs similar uterine activity in spontaneous normal labour whether the fetus presents as a vertex or breech, when controlled for parity.

Original languageEnglish
Pages (from-to)275-278
Number of pages4
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
Volume28
Issue number4
DOIs
Publication statusPublished - 1988

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