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

https://doi.org/10.1136/ebm.6.3.73

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    (2000) Lancet 356, 1375. Hannah ME, Hannah WJ, Hewson SA, et al, . for the Term Breech Trial Collaborative Group.. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial.. Oct 21;. :. –83.
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 QUESTION: In pregnant women with breech presentation, is planned caesarean section (CS) better than planned vaginal birth (VB)?

    Design

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

    Setting

    121 centres in 26 countries.

    Patients

    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.

    Intervention

    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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    Footnotes

    • 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.