Tag Archives: serious neonatal morbidity

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