Planned Caesarean decreases risk of complications in Breech Babies

Planned Caesarean decreases risk of complications in Breech Babies
The benefits of a planned caesarean compared with a planned vaginal birth were initially shown in the main report of the Term Breech Trial, an international multicentre randomised controlled trial which enrolled 2088 women from 121 centres in 26 countries.

The Trial compared planned Caesarean with planned vaginal birth for women with a singleton fetus in a frank or complete breech presentation at term at 37 weeks or more.

However, much of the concern around planning a vaginal birth for a singleton fetus in breech presentation at or near term has been the worry that the delivery of the head may not follow immediately after the rest of the body, either because the pelvis is too small, the fetal head is deflexed, or because the cervix is not completely dilated. This new report shows that there is also concern that the labour may be a problem for the fetus.

The results show a seven fold reduction in risk of adverse outcome due to labour with a planned caesarean compared with a planned vaginal birth, with close to a three fold reduction in risk of adverse outcome due to delivery.

Dr Mary Hannah says, “The results clarify that the problem with planning a vaginal birth for a breech baby at term is not just the concern of a higher risk of a difficult vaginal delivery. There is also a higher risk of problems because of the labour. The findings also raise questions as to whether a planned caesarean may be a better method of delivery for some babies that are presenting head first (or cephalic) for whom the labour is of concern.”

Ends

Notes to Editor:

Of the 2088 women enrolled in the Breech Term Trial, entry and outcome data were received for 2083 women, or whom 1041 were randomised to the planned caesarean group and 1042 were randomised to the planned vaginal birth group.

For more information please contact:

Dr Mary Hannah, Maternal Infant and Reproductive Health Research Unit, Centre for Research in Women’s Health, University of Toronto, Suite 751, 790 Bay Street, Toronto, Canada. Telephone: 001-416-351-3775 or email mary.hannah@sw.ca
Date published: 04/10/2003 - 01:00Published by: Simon KempNo of comments: 0
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