Observational studyActa obstetricia et gynecologica Scandinavica2025
Vaginal breech delivery in all-fours position-Hands off instead of intervention: A prospective observational study.
Observational study in Acta obstetricia et gynecologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Vaginal breech delivery in all-fours position-Hands off instead of intervention: A prospective observational study.Acta obstetricia et gynecologica Scandinavica · 2025Observational
- Effects of free-position delivery combined with perineal massage on reducing sensitive indicators of care quality in high-risk pregnant women.Frontiers in medicine · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionVaginal delivery in cases of breech presentation is considered potentially stressful for the newborn. The maternal upright position may represent a more physiological approach to facilitating birth. We compare the safety and efficacy of two maternal positions in vaginal breech delivery. MATERIAL AND
methodsA prospective, single-center, observational cohort study from October 2006 to January 2021 in a high-level obstetric center, in Salzburg, Austria. Vaginal breech deliveries in maternal all-fours position (n = 140) were compared with those in assisted supine position (n = 92). The primary outcome measures for neonatal morbidity included Apgar scores, pH levels, and the rate of transfer to the Neonatal Intensive Care Unit (NICU) postdelivery.
resultsIn the all-fours position, 51.4% (n = 72) of deliveries occurred without obstetric intervention. The second stage of labor was significantly shorter in the supine position (39.5 min [95% CI 28-47] versus all fours position 52 min [95% CI 42-63], p = 0.042). Umbilical artery pH levels did not differ significantly (7.21 [95% CI 7.19-7.23] versus 7.19 [95% CI 7.17-7.21] vs. p = 0.06). Nor did the APGAR scores at 5 and 10 min below eight (p = 0.697; p = 0.760). Maternal and neonatal morbidity also did not significantly differ. Transfer of neonates to NICU n = 12 (13%) versus n = 11 (7.9%), p = 0.097, transfer birth-related n = 6 (6.5%) versus n = 8 (5.7%), p = 0.803. The number of postpartum umbilical artery pH < 7.10 were n = 9 (9.8%) versus n = 28 (20%), p = 0.065. There was one reported neonatal death due to intracerebral hemorrhage in the supine position group.
conclusionsOur results indicate that vaginal breech delivery in the all-fours position seems to be comparable to supine position regarding neonatal safety. Additionally, the all-fours position shows potential for emergency management for unplanned breech deliveries by inexperienced attendants.
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