Födselshjelp til fostre i seteleie ved Oslo universitetssykehus, Ullevål fra 2000–2012
Engelsk titel: Obstetric care for breech presentations at Oslo University Hospital, Ullevål in the period 2000–2012
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Författare:
Henriksen, Lena
;
Knutsen, Hanne
;
Laine, Katariina
Email: lena.henriksen@oslomet.no
Språk: Nor
Antal referenser: 31
Dokumenttyp:
Artikel
;
Jämförande studie
UI-nummer: 19120122
Sammanfattning
Background: There is much debate concerning the best way to deliver breech fetuses. October 2000 saw the publication of the results of the Term Breech Trial (TBT), which concluded that a planned caesarean section was the safest mode of delivery for full-term breech babies. The study led to a major change in obstetrics, to the extent that most countries currently deliver breech fetuses by planned caesarean section. In Norway, the recommendation has been for vaginal delivery for selected groups of breech presentations, both before and after the TBT study.
Objective: The objective of this current study has been to describe clinical practice at Ullevål Hospital’s maternity unit in cases of breech presentation, and to study any changes introduced to the unit’s practice after 2000. We have also compared outcomes for newborn infants, measured by their Apgar score, for different modes of delivery.
Method: We carried out a retrospective registry study of women with breech presentation at ≥34 weeks of gestation at Oslo University Hospital, Ullevål over the period 2000–2012.
Results: In the course of the study period, Ullevål Hospital treated a total of 2986 women with breech presentation at ≥34 weeks of gestation. This amounted to an average of 3.8 per cent of all births at the hospital. In 2000, the percentage share of planned vaginal deliveries was 62.9. From 2001, the number of women selected for vaginal delivery fell in the period up to 2006, when the share reached its lowest level of 34.2 per cent. Numbers then rose again, and in 2012, a vaginal delivery was planned for 49.8 per cent of women with breech presentation. The odds for a low Apgar score, a measurement of the vitality of the newborn 5 minutes after birth, were higher if the infant was in the group selected for a planned vaginal delivery.
Conclusion: It appears that practice at Ullevål Hospital may have been influenced by the results of the TBT study published in 2000. Following a decline in the number of planned vaginal deliveries in the period up to 2007, numbers rose again near the end of the study period. Infants with a low Apgar score made up a larger proportion of the group selected for a vaginal delivery compared to the group selected for a planned caesarean section.