Intrapartum monitoring with cardiotocography and ST-waveform analysis in breech presentation: an observational study

BJOG : an International Journal of Obstetrics and Gynaecology
Jörg KesslerSusanne Albrechtsen

Abstract

To determine the electrocardiographic performance and neonatal outcome of pregnancies with breech presentation and planned vaginal delivery monitored with ST-waveform analysis (STAN). Prospective observational study. University hospital, Norway; 2004-2008. Singleton pregnancies with a gestational age above 35 + 6 weeks, breech presentation, selected for vaginal delivery and monitored with STAN. Common clinical guidelines for STAN monitoring were used. An experienced neonatologist graded the symptoms of neonatal encephalopathy. The outcome was compared with STAN-monitored high-risk deliveries in a vertex presentation (n = 5569) using logistic regression analysis. Frequency of ST events, indications of intervention for fetal distress, and neonatal morbidity and mortality. Breech presentation occurred in 750 of 23,219 (3.2%) deliveries, 625 (83%) of which were selected for vaginal delivery. Intrapartum monitoring by STAN was performed in 433 (69%). Compared with vertex presentations, fetuses in breech presentation had a lower risk of baseline T/QRS rise during labour [odds ratio (OR) = 0.7, 95% confidence interval (95% CI) = 0.7-0.9, P = 0.003] and a higher risk for intervention as a result of preterminal cardiotocogram (OR = 2.9,...Continue Reading

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Related Concepts

Heart Rate, Fetal
Morbidity Aspects
Fetal Distress
Gestational Age
Breech Presentation
Pregnancy Complications
High-Risk Pregnancy
Fetal Monitoring
Fetal Hypoxia
Incomplete Breech Presentation

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