{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:51:38Z","timestamp":1777632698065,"version":"3.51.4"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T00:00:00Z","timestamp":1681689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In high altitude areas, like Tibet, most fetuses in breech presentation at term are delivered vaginally owing to a variety of reasons, but this has not been published.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to provide references and evidence for the delivery of breach presentation term fetuses in high altitude areas, through comparing and analyzing the data of full-term singleton fetuses with breech or cephalic presentation in Naqu People\u2019s Hospital, Tibet.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>We retrospectively analyzed the clinical data of 451 breech presentation fetuses mentioned above over a period of 5\u2009 years (2016\u20132020). A total of 526 cephalic presentation fetuses\u2019 data within 3\u2009 months (1 June to 1 September 2020) of the same period were collected too. Statistics were compared and assembled on fetal mortality, Apgar scores, and severe neonatal complications for both planned cesarean section (CS) and vaginal delivery. In addition, we also analyzed the types of breech presentation, the second stage of labor, and damage to the maternal perineum during vaginal delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 451 cases of breech presentation fetuses, 22 cases (4.9%) elected for CS and 429 cases (95.1%) elected for vaginal delivery. Of the women who chose vaginal trial labor, 17 cases underwent emergency CSs. The perinatal and neonatal mortality rate was 4.2% in the planned vaginal delivery group and the incidence of severe neonatal complications was 11.7% in the transvaginal group, no deaths were detected in the CS group. Among the 526 cephalic control groups with planned vaginal delivery, the perinatal and neonatal mortality was 1.5% (<jats:italic>p<\/jats:italic>\u2009=\u20090.012), and the incidence of severe neonatal complications was 1.9%. Among vaginal breech deliveries, most of them were complete breech presentation (61.17%). Among the 364 cases, the proportion of intact perinea was 45.1%, and first degree lacerations accounted for 40.7%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the Tibetan Plateau region, vaginal delivery was less safe than cephalic presentation fetuses for full-term breech presentation fetuses delivered in the lithotomy position. However, if dystocia or fetal distress can be identified in time and then encouraged to convert to cesarean, its safety will be greatly improved.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1048628","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T13:11:44Z","timestamp":1681737104000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Term breech presentation vaginal births in Tibet: A retrospective analysis of 451 cases"],"prefix":"10.3389","volume":"10","author":[{"given":"Fang","family":"Long","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keqing","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongxing","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duoji","family":"Zhaxi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoguang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhigang","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/1471-0528.13524","article-title":"The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies","volume":"123","author":"Berhan","year":"2016","journal-title":"BJOG"},{"key":"ref2","first-page":"511","article-title":"Recent trends in cesarean section use in California","volume":"153","author":"Stafford","year":"1990","journal-title":"West J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1097\/00006250-200311000-00006","article-title":"Vaginal versus cesarean delivery for breech presentation in California: a population-based study","volume":"102","author":"Gilbert","year":"2003","journal-title":"Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"59.e1","DOI":"10.1016\/j.ajog.2007.11.059","article-title":"Population trends in cesarean delivery for breech presentation in the United States, 1997-2003","volume":"199","author":"Lee","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"105.e1","DOI":"10.1016\/j.ajog.2018.04.012","article-title":"Cesarean delivery in the United States 2005 through 2014: a population-based analysis using the Robson 10-group classification system","volume":"219","author":"Hehir","year":"2018","journal-title":"Am J Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1016\/S0140-6736(00)02840-3","article-title":"Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. 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