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Planned caesarean section had lower risk for perinatal morbidity and mortality than planned vaginal birth in breech presentation

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 QUESTION: In pregnant women with breech presentation, is planned caesarean section (CS) better than planned vaginal birth (VB)?


Randomised (allocation concealed*), unblinded,* controlled trial with 6 weeks postpartum follow up.


121 centres in 26 countries.


2088 pregnant women who had a singleton live fetus in a frank or complete breech presentation at ≥37 weeks of gestation. Exclusion criteria were fetopelvic disproportion, fetus estimated to be clinically large or ≥4000 g, hyperextension of the fetal head, fetal anomaly or risk for mechanical problems at delivery, or contraindication for labour or vaginal delivery. 2083 women and infants (99.8%) had complete follow up.


Women were allocated to planned CS (n=1043) or planned VB (n=1045). Women in the CS group were scheduled for a CS at ≥38 weeks of gestation. Women in …

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  • Sources of funding: Canadian Institutes of Health Research; Centre for Research in Women's Health; Sunnybrook and Women's College Health Sciences Centre; University of Toronto.

  • For correspondence: Dr M E Hannah, University of Toronto, Maternal Infant and Reproductive Health Research Unit, Centre for Research in Women's Health, Toronto, Ontario M5G 1N8, Canada.

  • * See glossary.