title: [Fetal heart rate patterns of breech presentations during expulsion. A comparative study with cephalic presentations].
abstract: BACKGROUND
  Expulsion upon vaginal delivery is a period at risk for the foetus, especially in case of breech presentation. In fact, monitoring the fetal well-being is complex in this phase. The correct interpretation of fetal heart rate (FHR) during expulsion, using Melchior's classification, is important because it helps screen for fetal acidosis. The aim of this study was to determine if it was possible to tolerate an abnormal FHR during expulsion of breech presentations.
  
  
  METHODS
  A retrospective study was conducted to compare FHR during expulsion and neonatal results between breech and cephalic presentations at Besançon's university hospital.
  
  
  RESULTS
  We collected data from 118 breech presentations and 236 cephalic presentations. Melchior's FHR classification types were significantly different between breech and cephalic presentations with a majority of type 1. Neonatal results were significantly less favorable for breech presentations, but without any increase in mortality and in severe morbidity.
  
  
  CONCLUSIONS
  Melchior's expulsion FHR classification seems to be applicable for breech presentations with a different distribution of FHR types compared to cephalic presentations. Following the results of this study, it seems to be possible to tolerate an abnormal FHR during expulsion of breech presentation, so far as is reasonable.
authors.affiliation: Pôle Mère-Femme, CHU Jean-Minjoz, 25000 Besançon, France.
authors.forename: A
authors.initials: A
authors.lastname: Bourtembourg
authors.affiliation: Pôle Mère-Femme, CHU Jean-Minjoz, 25000 Besançon, France.
authors.forename: R
authors.initials: R
authors.lastname: Ramanah
authors.affiliation: Pôle Mère-Femme, CHU Jean-Minjoz, 25000 Besançon, France.
authors.forename: A
authors.initials: A
authors.lastname: Martin
authors.affiliation: Pôle Mère-Femme, CHU Jean-Minjoz, 25000 Besançon, France.
authors.forename: A
authors.initials: A
authors.lastname: Pugin-Vivot
authors.affiliation: Pôle Mère-Femme, CHU Jean-Minjoz, 25000 Besançon, France.
authors.forename: R
authors.initials: R
authors.lastname: Maillet
authors.affiliation: Pôle Mère-Femme, CHU Jean-Minjoz, 25000 Besançon, France. Electronic address: didier.riethmuller@univ-fcomte.fr.
authors.forename: D
authors.initials: D
authors.lastname: Riethmuller
mesh_terms: D001946:Breech Presentation / Q000503:physiopathology*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D006340:Heart Rate, Fetal / Q000502:physiology*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*
keywords: Breech; Classification de Melchior; Comparative study; Expulsion; Fetal heart rate; Melchior's expulsion FHR classification; Rythme cardiaque fœtal; Siège; Étude comparative