Induction of labor in breech presentation at term: a retrospective cohort study.
OBJECTIVE
To compare the outcome of two methods of labor induction and spontaneous onset of labor in breech presentation at term.


METHODS
A retrospective study between 2003 and 2012. We compare obstetric (indication of induction, Bishop score, cesarean rate) and perinatal outcomes (Apgar score, umbilical artery pH, base excess ≤-12 mmol/L, admission to neonatal unit) between prostaglandins and oxytocin. We also compare labor induction versus spontaneous onset of labor.


RESULTS
Of the 1684 breech deliveries, we carried out labor induction in 221 cases (76% with prostaglandins, 24% with oxytocin). The prostaglandins group had significantly lower Bishop scores and the time for induction phase was significantly higher. There were no differences in cesarean rate between both methods of induction or spontaneous onset of labor. The prostaglandins group had higher rates of base excess ≤-12 mmol/L. Compared with spontaneous onset of labor in breech presentation, induction had significant lower rates of newborn weight and higher rates of admission to the neonatal unit.


CONCLUSIONS
Induction of labor in breech presentation at term is a reasonable and effective option after a careful selection of cases. It was not associated with an increase of perinatal morbidity or cesarean rate compared with spontaneous onset of labor.
Obstetrics and Gynecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces, C/Plaza de Cruces 12, 48903, Baracaldo, Biscay.
Jorge
J
Burgos
University of the Basque Country (UPV/EHU), Biscay.
Itziar
I
Arana
University of the Basque Country (UPV/EHU), Biscay.
Ignacio
I
Garitano
University of the Basque Country (UPV/EHU), Biscay.
Leire
L
Rodríguez
University of the Basque Country (UPV/EHU), Biscay.
Patricia
P
Cobos
University of the Basque Country (UPV/EHU), Biscay.
Carmen
C
Osuna
University of the Basque Country (UPV/EHU), Biscay.
María
M
Del Mar Centeno
University of the Basque Country (UPV/EHU), Biscay.
Luis
L
Fernández-Llebrez
D001946:Breech Presentation / Q000601:surgery*; D002585:Cesarean Section; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000379:methods; D015232:Dinoprostone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007745:Labor Onset; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics / Q000627:therapeutic use; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013030:Spain; D047929:Term Birth
D010120:Oxytocics; D010121:Oxytocin; D015232:Dinoprostone
Breech presentation; cesarean section; delivery; induced; labor; obstetric; oxytocin; prostaglandins