Tag Archives: Breech-COS

Breech-COS meeting: May 8, 2024

Avni Batish and Kate Stringer, photo by George Haroun

On May 8th, we will be holding an online meeting to establish a consensus on short-term outcomes in our Breech-COS study. We invite anyone with an interest to attend. Book here to attend.

The RCOG training day has been postponed.

Papers to inform the above events:

Walker S, Dasgupta T, Halliday A, Reitter A. Development of a core outcome set for effectiveness studies of breech birth at term (Breech-COS): A systematic review on variations in outcome reportingEur J Obstet Gynecol Reprod Biol. 2021;263:117-126. doi:10.1016/j.ejogrb.2021.06.021

Walker S, Dasgupta T, Shennan A, Sandall J, Bunce C, Roberts P. Development of a core outcome set for effectiveness studies of breech birth at term (Breech-COS)—an international multi-stakeholder Delphi study: study protocol. Trials. 2022;23(1):249. doi:10.1186/s13063-022-06136-9

How it began …

Shawn Walker is funded by a National Institute of Health and Care Research (NIHR) Advanced Fellowship (300582, OptiBreech).

Webinar 30 August 5PM: Testicular complications of vaginal breech birth

Join the webinar using this Zoom link: https://us02web.zoom.us/j/88170521832?pwd=U1RUSzhPNTJ3elVRSFRuL3c2bGszQT09

David Coggin-Carr is a UK+US dual-certified obstetrician, Maternal-Fetal Medicine subspecialist and early career physician-scientist at the University of Vermont (UVM). He practices full-spectrum MFM in Vermont and upstate New York and additionally serve as Associate Medical Director of the Birthing Center and Associate Director of Quality for Obstetrics at UVM Medical Center. In recent years he has developed a strong interest in physiological breech birth in response to the local community’s desire for greater autonomy around their birth choices amidst a near-total lack of trained/experienced providers in the region. Accordingly, he now regularly provides consultations and intrapartum support for planned vaginal breech birth.

Image: Book of Traceable Heraldic Art

All births have the potential for injury, whether this be facial markings from forceps delivery or lacerations from a caesarean birth. Vaginal breech birth has its own variations. This webinar will explore how vaginal breech birth affects neonatal genitals, both normal variations in appearance from being born bottom-first, to potential injuries.

We will also discuss what research on genital injuries should be done, and how these should be measured and reported in clinical trials. This discussion will inform the on-going Breech-COS (core outcome set) in the OptiBreech research programme.

We will discuss and consider the statements:

There should be no requirement to report genital injury as a separate category in ALL effectiveness studies of breech birth at term, although it may be reported in some. It should not be included in the Breech-COS composite measure of severe morbidity.

or

The incidence of significant genital injury, defined as one that is likely to have long-term, life-altering consequences, should be reported as a separate category in ALL effectiveness studies of breech birth at term. Significant genital injury should be included in the Breech-COS composite measure of severe neonatal morbidity associated with vaginal breech birth.

For all sites that have expressed an interest in our planned stepped wedge trial of OptiBreech collaborative care: please include your name and hospital in the chat, and we will award one site selection point for every site that participates.

References

Kekki, M., Koukkula, T., Salonen, A., Gissler, M., Laivuori, H., Huttunen, T.T., Tihtonen, K., 2022. Birth injury in breech delivery: a nationwide population-based cohort study in Finland. Arch. Gynecol. Obstet. https://doi.org/10.1007/S00404-022-06772-1

Habek, D., 2023. Traumatic testicular avulsion during amniotomy in vaginal breech delivery. Eur. J. Obstet. Gynecol. Reprod. Biol. https://doi.org/10.1016/j.ejogrb.2022.12.003

Breech-COS international study

Round 1 of the international multi-stakeholder Delphi study, Development of a Core Outcome Set for Effectiveness Studies of Breech Birth at Term (Breech-COS) is now open. We invite the involvement of anyone from the following stakeholder groups, who has experience of care for women having vaginal breech births:

QR code for Breech-COS Round 1
  • obstetrician
  • midwife
  • service users (you or your partner have had a breech-presenting baby within the last 5 years)
  • neonatologist
  • researcher
  • health services manager
  • healthcare commissioner
  • health economist
  • statistician
  • support group representative
  • other relevant roles

You can read more information about the research and participate using the link or the QR code below. You are welcome to share this post or forward to your stakeholder associates.

Participation Linkhttps://qualtrics.kcl.ac.uk/jfe/form/SV_b4uw2QJxcTC8oZM

This consensus-building activity follows on from our systematic review, including Patient and Public Involvement (PPI) activity, Development of a core outcome set for effectiveness studies of breech birth at term (Breech-COS): A systematic review on variations in outcome reporting.

Shawn Walker, on behalf of the OptiBreech team