Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group.
Background: For 3-4% of pregnancies, the fetus will be in the breech presentation at term. For most of these women, the approach to delivery is controversial. We did a randomised trial to compare a policy of planned caesarean section with a policy of planned vaginal birth for selected breech-present...
| Published in: | Lancet Vol. 356; no. 9239; pp. 1375 - 1384 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | clinical trial research tables/charts Journal Article |
| Published: |
Lancet
10/21/2000
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107015619&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107015619 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 10/21/2000 vid: 356 iid: 9239 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 107015619 107015619 NLM11052579 2001033801 10.1016/s0140-6736(00)02840-3 NLM11052579 107015619 ppf: 1375 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. aug: au: Hannah ME Hannah WJ Hewson SA Hodnett ED Saigal S Willan AR Hannah, M E Hannah, W J Hewson, S A Hodnett, E D Saigal, S Willan, A R affil: Department of Obstetrics and Gynaecology, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada sug: subj: Breech Presentation Cesarean Section Pregnancy Outcomes Infant Mortality Pregnancy Female Vaginal Birth Pregnancy Complications Fisher's Exact Test Wilcoxon Rank Sum Test Relative Risk Confidence Intervals Infant, Newborn Adult Parity Clinical Trials Funding Source Human Infant, Newborn: birth-1 month Adult: 19-44 years Female ab: Background: For 3-4% of pregnancies, the fetus will be in the breech presentation at term. For most of these women, the approach to delivery is controversial. We did a randomised trial to compare a policy of planned caesarean section with a policy of planned vaginal birth for selected breech-presentation pregnancies.Methods: At 121 centres in 26 countries, 2088 women with a singleton fetus in a frank or complete breech presentation were randomly assigned planned caesarean section or planned vaginal birth. Women having a vaginal breech delivery had an experienced clinician at the birth. Mothers and infants were followed-up to 6 weeks post partum. The primary outcomes were perinatal mortality, neonatal mortality, or serious neonatal morbidity; and maternal mortality or serious maternal morbidity. Analysis was by intention to treat.Findings: Data were received for 2083 women. Of the 1041 women assigned planned caesarean section, 941 (90.4%) were delivered by caesarean section. Of the 1042 women assigned planned vaginal birth, 591 (56.7%) delivered vaginally. Perinatal mortality, neonatal mortality, or serious neonatal morbidity was significantly lower for the planned caesarean section group than for the planned vaginal birth group (17 of 1039 [1.6%] vs 52 of 1039 [5.0%]; relative risk 0.33 [95% CI 0.19-0.56]; p<0.0001). There were no differences between groups in terms of maternal mortality or serious maternal morbidity (41 of 1041 [3.9%] vs 33 of 1042 [3.2%]; 1.24 [0.79-1.95]; p=0.35).Interpretation: Planned caesarean section is better than planned vaginal birth for the term fetus in the breech presentation; serious maternal complications are similar between the groups. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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