Comparison of outcomes between induction of labor and spontaneous labor for term breech – A systemic review and meta analysis

  • Wen Sun
    Affiliations
    Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China

    OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada
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  • Fen Liu
    Affiliations
    Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China
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  • Shiliang Liu
    Affiliations
    Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China

    Public Health Agency of Canada, Ottawa, Canada
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  • Sara-Michelle Gratton
    Affiliations
    OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada

    Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada
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  • Darine El-Chaar
    Affiliations
    OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada

    Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada
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  • Shi Wu Wen
    Correspondence
    Corresponding author at: 501 Smyth Rd, Box 241 Ottawa, K1H 8L6, Canada.
    Affiliations
    OMNI Research Group, Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Canada

    Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Canada

    School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa Faculty of Medicine, Ottawa, Canada
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  • Dunjin Chen
    Correspondence
    Corresponding author at: 63 Duobao Rd, Liwan District, Guangzhou, China.
    Affiliations
    Department of Obstetrics and Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Key Laboratory for Major Obstetric Diseases of Guangdong Province, Guangzhou, China
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Published:December 15, 2017DOI:https://doi.org/10.1016/j.ejogrb.2017.12.031

      Abstract

      Objectives

      Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity.

      Methods

      Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included. Perinatal morbidity was calculated by RevMan 5 and presented by pooled odds ratio with 95% confidence intervals.

      Results

      Cesarean section rate and neonatal intensive care unit admission were increased in induction of breech labor as compared with spontaneous breech labor. No significant difference in umbilical cord blood base excess ≤ −12 mmol/L, Apgar 5 min < 7, Apgar 5 min < 4, umbilical cord blood PH < 7, neonatology unit admission, maternal fever, and intrapartum stillbirth between the two groups was found.

      Conclusions

      Induction of breech labor has higher cesarean section rate and NICU perinatal morbidity compared to spontaneous breech labor. The neonatal outcomes were otherwise similar across both groups. Eligibility for induction of breech labor needs to be assessed carefully according to individual situation.

      Keywords

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