Recommendations on routine mid-trimester anomaly scan.

The purpose of this paper is to discuss the minimal requirements of the routine mid-trimester anomaly scan in Asian countries after taking into account various factors, including local circumstances, medical practice, guidelines, and availability of experienced sonographers and high-resolution ultrasound machines, which affect the prenatal detection rate of fetal anomalies. In general, a routine mid-trimester anomaly scan includes the assessment of the number of fetuses, fetal cardiac activity, size, anatomy, liquor and placental location. The most controversial issue is which fetal structures should at least be examined. We discussed the requirements of a basic routine scan, as well as the optional views, which can be obtained if feasible to improve the detection of fetal, placental or maternal abnormalities. Routine anomaly scan remains a clinical challenge.

Vaginal versus cesarean breech delivery: Maternal and neonatal outcome at Bulacan Medical Center - A two-year retrospective study / Philippine Journal of Obstetrics and Gynecology

OBJECTIVE: To compare the maternal and neonatal outcome of vaginal and cesarean breech deliveries at Bulacan Medical Center MATERIALS AND METHODS: A two-year retrospective descriptive study on all patients who delivered breech by vaginal or cesarean section from January 1, 2012 to December 31, 2013. The maternal and neonatal outcomes were compared and analyzed. RESULTS: There were 165 deliveries included during the study period. There were 83 cases of vaginal breech delivery and 82 cases of cesarean breech delivery. The incidence and risk of postpartum hemorrhage is higher among cesarean breech delivery (7%). Febrile morbidity (p=0.0223) is significantly lower for vaginal breech births. Cesarean breech delivery is correlated with longer hospital stay (p= CONCLUSION: There is no significant difference in maternal and perinatal morbidity and mortality between vaginal and cesarean breech delivery except for longer hospital stay and increased febrile morbidity for cesarean births. It is therefore safe to recommend vaginal breech delivery under hospital-specific guidelines for labor management such as strict selection of patients, high quality fetal monitoring and high level of competence among obstetricians to deliver breech.