Journal of Health & Medical Informatics

Early Intervention in Breech Presentation to Reduce of Cesarean Section and Breech Deliveries

Abstract

Tsuneaki Tsuzaki*,Kazuhiko Ozaki,Kazuya Arata,Kazuo Maeda

The effect of early intervention in breech presentation is investigated by outcomes of two indices: the breech delivery rate and the breech cesarean rate. Historically-controlled retrospective study was performed from 1985 to 2012. We intervene the breech presentation with tocolysis and external cephalic version (ECV) after 32 weeks’ of pregnancy and compared two indices before introduction of ECV (1985-87) and after (1986-2012). Statistical study was carried by kaisu are test and P value less than 0.05 is significant. Utilized tocolytic agents were ritdor in hydrochloride and magnesium sulfate. ECV was performed after 24 hrs in admission. Within enrolled case of 478, one hundred and sixty two cases were office ECV was excluded due to no controls (unsuccessful cases). Adopted 316 cases of admission-controlled ECV was divided into two groups of ECV (245 cases) and no ECV (71 cases). Spontaneous version had occurred in 20 cases of ECV and in 58 cases of no ECV, so overall spontaneous version rate was 25% (78/316) and overall successful ECV rate was 66% (161/245) under low reversion rate of 2.8% (9/323). In this way, two indices of the breech delivery rate and breech cesarean section rate had reduced from 3.3 to 2.1% and from 21.3 to 12.7% respectively (p<0.01). Furthermore we have not experienced serious complications. So we considered early intervention in breech presentation with tocolysis and ECV is useful for reduction of breech delivery and breech cesarean section.