Toivonen Elli, Palomäki Outi, Huhtala Heini, Uotila Jukka
School of Medicine, University of Tampere, Tampere, Finland.
Birth. 2014 Dec;41(4):316-22. doi: 10.1111/birt.12119. Epub 2014 Jun 17.
The optimal mode of breech birth remains controversial. In Finland, a trial of vaginal delivery is possible if strict selection criteria are met. As clinical practice in managing vaginal breech birth differs from that in normal delivery, the birth experience may also be different. This cohort study compares the childbirth experience between term breech and vertex deliveries.
Intended vaginal term breech births from 2008 to October 2012 were included, and for every breech delivery, a vertex control was selected. The proportions of deliveries ending in a cesarean section and of mothers who had given birth vaginally before were equal in both groups. Three hundred eight mothers were sent the childbirth experience questionnaire and 170 returned it.
The birth experience does not differ between breech and vertex births, except for aspects with respect to the choice of birthing position. Indications of an even more positive experience were observed in the breech group, with the exception of the choice of analgesia, but these were not statistically significant. Primiparity, emergency cesarean section, infant birth trauma and prolonged hospital stay were identified as risk factors for a negative birth experience.
The birth experience of vaginal breech birth seems to be at least as positive as the vaginal vertex birth experience.
臀位分娩的最佳方式仍存在争议。在芬兰，如果满足严格的选择标准，尝试阴道分娩是可行的。由于阴道臀位分娩的临床处理方式与正常分娩不同，分娩体验可能也会有所差异。这项队列研究比较了足月臀位分娩和头位分娩的分娩体验。
纳入2008年至2012年10月期间计划经阴道足月臀位分娩的产妇，每例臀位分娩均选取一名头位分娩的产妇作为对照。两组剖宫产分娩比例及既往有阴道分娩史的产妇比例均相等。向308名母亲发放了分娩体验问卷，170名母亲回复了问卷。
除分娩体位选择方面外，臀位分娩和头位分娩的分娩体验并无差异。在臀位组观察到有更积极体验的迹象，但镇痛方式选择除外，不过这些差异无统计学意义。初产、急诊剖宫产、婴儿出生创伤和住院时间延长被确定为负面分娩体验的危险因素。
阴道臀位分娩的分娩体验似乎至少与阴道头位分娩体验一样积极。
