{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T06:40:04Z","timestamp":1775198404129,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T00:00:00Z","timestamp":1579478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We aimed to identify common features of upright vaginal breech births with good outcomes to refine a physiological approach to teaching breech birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a structured analysis of 42 videos of successful upright breech births (eg, kneeling, hand\/knees), facilitated by obstetricians (n\u00a0=\u00a034) and midwives (n\u00a0=\u00a08) in nine different countries. Precise timings and relevant clinical details were recorded on an Excel spreadsheet. Each video was analyzed twice by at least two members of the research team. Time\u2010to\u2010event intervals, frequencies of interventions, and descriptive statistics were calculated using SPSS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A completely spontaneous (labor mechanisms and maternal effort only) birth occurred in 14\/42 (33%) cases. The median time between the birth of the fetal pelvis and the head in all births was 1:52 (IQR 1:05,2:46; min:sec). Lack of spontaneous rotation to a sacro\u2010anterior position by the time the fetus had emerged to the nipple line was strongly associated with fetal arm entrapment. The following maneuvers were used: shoulder press to flex the aftercoming head in midpelvis or outlet (n\u00a0=\u00a024), sweeping down arm\/s (n\u00a0=\u00a012), buttock lift to assist shoulder press (n\u00a0=\u00a06), modified Mauriceau (n\u00a0=\u00a06), rotational maneuvers to release an entrapped arm (n\u00a0=\u00a06), elevate and rotate fetal head to assist engagement (n\u00a0=\u00a02), and conversion into supine maternal position (n\u00a0=\u00a02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most upright breech births occur within 3\u00a0minutes of the birth of the fetal pelvis. Upright breech birth attendants use variations of traditional maneuvers. We introduce a physiological breech algorithm as an initial timekeeping framework for teaching, research, and practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12480","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T03:34:40Z","timestamp":1579577680000},"page":"211-219","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Practical insight into upright breech birth from birth videos: A structured analysis"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5737-3033","authenticated-orcid":false,"given":"Anke","family":"Reitter","sequence":"first","affiliation":[{"name":"Obstetric and Prenatal Medicine Department Hospital Sachsenhausen Academic Teaching Hospital of the Goethe\u2010University Frankfurt Frankfurt 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