Uterine incision extensions and need for blood transfusions were highest in the failed cephalic extraction subgroup
Uterine incision extensions: 45.8%
Need for blood transfusions: 22%
Inverted T-incision rates
Similar rates between attempted cephalic extraction group vs breech extraction group
Subgroup analysis: Higher rate of T incisions observed in failed cephalic extraction subgroup (p< 0.001)
Failed cephalic group: 13.6%
Successful cephalic extraction group: 0.3%
Successful breech extraction groups: 1.7%
No significant differences between attempted cephalic extraction group and the breech extraction group (including Apgar scores, low pH or NICU admission)
Subgroup analysis: In failed cephalic extraction subgroup, there were higher rates of
Low 1-minute Apgar scores (p = 0.016)
NICU hospitalizations (p =0.01)
Limb fractures (p < 0.001)
In second stage cesarean, breech extraction was associated with less maternal morbidity compared to attempted cephalic extraction
There were no significant differences in neonatal morbidities for the two extraction methods
However, both maternal and neonatal morbidity were increased in the failed cephalic extraction group
The authors state that
Given the apparent benefits of breech extraction, obstetricians who are experienced in the procedure may consider this mode of extraction in second‐stage caesarean section the preferred mode of delivery
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