Carayol M, Alexander S, Goffinet F, Bréart G, Alexander S, Uzan S, Subtil D, Carayol M, Foidart J M
INSERM U149, Hôpital Tenon, 75020 Paris.
J Gynecol Obstet Biol Reprod (Paris). 2004 Feb;33(1 Suppl):S37-44. doi: 10.1016/s0368-2315(04)96663-x.
The purpose of this work was to report labor and birth management practices for term breech presentation in France and Belgium in 2001-2002 and to describe indications for cesarean sections (before labor, emergency situations) in breech presentations.
The PREMODA cohort is a survey population which included 19408 deliveries, 8108 of which were term breech presentations.
Infants were delivered by cesarean section before labor (59.1%), emergency cesarean section during labor (18.4%) or vaginally (22.5%). The decision for cesarean section before labor was empirical (breech presentation) in 44.3% of the cases. Half of the cesarean sections performed during labor (n=704, 49.3%) were planned C-sections. Overall, 67.8% of the breech presentations were delivered during planned cesarean sections (before or during labor). When vaginal delivery was attempted, the rate of vaginal birth was 70%.
These early results reveal a high rate of cesarean section as well as differences in inter-regional practices. Considering all cesarean sections performed before labor, the most frequent indication was an empirical decision because of the breech presentation. An increased rate of planned cesarean section does not reduce the rate of vaginal delivery when attempted.
本研究旨在报告2001 - 2002年法国和比利时足月臀位分娩的产程及分娩管理实践，并描述臀位剖宫产（临产前、紧急情况）的指征。
PREMODA队列是一个调查人群，包括19408例分娩，其中8108例为足月臀位分娩。
婴儿通过临产前剖宫产（59.1%）、产时紧急剖宫产（18.4%）或阴道分娩（22.5%）。44.3%的临产前剖宫产决定是基于经验（臀位）。产时进行的剖宫产中有一半（n = 704，49.3%）是计划剖宫产。总体而言，67.8%的臀位分娩是在计划剖宫产时（临产前或产时）进行的。尝试阴道分娩时，阴道分娩率为70%。
这些早期结果显示剖宫产率较高以及地区间实践存在差异。考虑到所有临产前进行的剖宫产，最常见的指征是基于臀位的经验性决定。计划剖宫产率的增加并未降低尝试阴道分娩时的阴道分娩率。
