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These data alone will do little to change practice, but paired with an Increased focus on training with respect to vaginal twin delivery--including in cases of breech presentation of the second baby--they could lead to Improved maternal outcomes, he explained, adding that "breech extraction can be very fast and safe in skilled hands."
Of course, we have become enthusiastic about using reverse breech extraction in difficult cases since your article a few years ago.
of % t' value Significance cases Nonreassuring foetal 18 54.5 7.837 0.000 heart rate Previous LSCS with PROM 1 3.0 Failed induction 2 6.1 Breech 2 6.1 CPD 9 27.3 Twin 1 3.0 Table 9: Relation of Bishop Score on Admission to Mode of Delivery Mode of Delivery Bishop score <6 [greater than or equal to] 6 51 (68%) 24 (32%) FTVD with RMLE 8 (15.7%) 10(41.7 %) Assisted breech extraction 1 (2%) 2(8.3%) Outlet forceps delivery with RMLE 14 (27.5%) 7 (29.2%) Vacuum Delivery 0 (0%) 0 (0%) LSCS 28 (54.9%) 5 (20.8%) Mode of Delivery Chi- square Significance value FTVD with RMLE 10.569 0.015 Assisted breech extraction Outlet forceps delivery with RMLE Vacuum Delivery LSCS Table 10: Amniotic Fluid Culture from Suspected Cases Total No .of cases 40 Organism No.
The second twin delivered by spontaneous vaginal delivery in 29(58%), vacuum delivery 3(6%), spontaneous breech delivery in 5(10%), assisted breech delivery in 7(14%), breech extraction in 3(6%), internal podalic version and breech extraction in 3 (6%).
The impact of defensive medical practice and the decline in traumatic rupture may be the other reasons for our low incidence.2,4 The predisposing factors of UR in developing countries have been demonstrated as: age 31-35, para (greater than)3, and poor antenatal care, grandmultiparity, obstetric trauma from prolonged or neglected labour, malpresentation, external and internal podalic version, breech extraction, manual cervical dilatation, and injudicious use of oxytocin, prostaglandins by untrained paramedics and previous unknown corporeal scar.5,7-10 In our series, the average parity was higher than 4.
Delivery was attended by a registrar and noted as a breech extraction. The 5-minute Apgar score was 3 and the birth weight was 3 220 g.
The fetus was delivered from a vertex presentation by breech extraction. The infant weighed 2187 grams and had apgar scores of 7 and 7 at 1 and 5 minutes respectively.