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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, MD, FRCOG, Joachim W.

Ed. by Bancalari, Eduardo / Chappelle, Joseph / Chervenak, Frank A. / D'Addario , Vincenzo / Genc, Mehmet R. / Greenough, Anne / Grunebaum, Amos / Konje, Justin C. / Kurjak M.D., Asim / Romero, Roberto / Zalud, MD PhD, Ivica


IMPACT FACTOR 2018: 1.361
5-year IMPACT FACTOR: 1.578

CiteScore 2018: 1.29

SCImago Journal Rank (SJR) 2018: 0.522
Source Normalized Impact per Paper (SNIP) 2018: 0.602

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1619-3997
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Volume 30, Issue 3

Issues

Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable? – A blinded controlled audit

L. Krebs / J. Langhoff-Roos / B. Bødker
Published Online: 2005-06-01 | DOI: https://doi.org/10.1515/JPM.2002.030

Abstract

The aim of the study was to investigate whether deaths in term breech deliveries could have been avoided with improved care during pregnancy and delivery.

All cases of intrapartum/early neonatal death of nonmalformed infants in breech presentation delivered at term in Denmark in the period 1982–92 were studied. For each of the 12 deaths two controls matched by presentation and planned mode of delivery were selected. Eleven obstetricians assessed the care through narratives that ended when the infant was delivered to umbilicus and stated if the infant died, and whether the “possible death” was potentially avoidable.

The majority thought that 42% of cases and 9% of the controls had died. Antenatal and intrapartum care was suboptimal respectively in 17% and 25% of cases and 4% and 26% of controls. The assumed death was found to have been potentially avoidable in 58% of cases and 17% of controls. Care in pregnancies with IUGR, preeclampsia, placental abruption, post-maturity, the time from decision to performance of cesarean section, and compliance between patient and professionals were more often criticized in cases than in controls. Controlled audit seemed to be a valuable tool for quality improvement and for validation of litigation activities.

In conclusion, infant death at term breech delivery was to a large extent potentially avoidable. However, even in controls, suboptimal care was not uncommon.

About the article

Published Online: 2005-06-01

Published in Print: 2002-06-03


Citation Information: Journal of Perinatal Medicine, Volume 30, Issue 3, Pages 220–224, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2002.030.

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