Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial
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 pregna...
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| Veröffentlicht in: | The Lancet (British edition) 2000-10, Vol.356 (9239), p.1375-1383 |
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| creator | Hannah, Mary E Hannah, Walter J Hewson, Sheila A Hodnett, Ellen D Saigal, Saroj Willan, Andrew R |
| description | 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.
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.
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 |
| doi_str_mv | 10.1016/S0140-6736(00)02840-3 |
| format | Article |
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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.
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).
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.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(00)02840-3</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Biological and medical sciences ; Births ; Cesarean section ; Clinical trials ; Delivery. Postpartum. Lactation ; Gynecology. Andrology. Obstetrics ; Infant mortality ; Maternal mortality ; Medical sciences ; Morbidity ; Neonates ; Obstetrical techniques ; Pregnancy</subject><ispartof>The Lancet (British edition), 2000-10, Vol.356 (9239), p.1375-1383</ispartof><rights>2000 Elsevier Ltd</rights><rights>2000 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Oct 21, 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-31bd980b2d043e344344f6e2478229d61650b0328a22732c8fd996ec6ffcba873</citedby><cites>FETCH-LOGICAL-c447t-31bd980b2d043e344344f6e2478229d61650b0328a22732c8fd996ec6ffcba873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673600028403$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1518241$$DView record in Pascal Francis$$Hfree_for_read</backlink></links><search><creatorcontrib>Hannah, Mary E</creatorcontrib><creatorcontrib>Hannah, Walter J</creatorcontrib><creatorcontrib>Hewson, Sheila A</creatorcontrib><creatorcontrib>Hodnett, Ellen D</creatorcontrib><creatorcontrib>Saigal, Saroj</creatorcontrib><creatorcontrib>Willan, Andrew R</creatorcontrib><creatorcontrib>Term Breech Trial Collaborative</creatorcontrib><title>Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial</title><title>The Lancet (British edition)</title><description>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.
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.
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).
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.</description><subject>Biological and medical sciences</subject><subject>Births</subject><subject>Cesarean section</subject><subject>Clinical trials</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Infant mortality</subject><subject>Maternal mortality</subject><subject>Medical sciences</subject><subject>Morbidity</subject><subject>Neonates</subject><subject>Obstetrical techniques</subject><subject>Pregnancy</subject><issn>0140-6736</issn><issn>1474-547X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkVuLFDEQhYMoOK7-BCGIoPvQWrl0utuXRZb1AgsKKvgW0ulqN0tP91iVHvDfm50ZFHwRAkXgO3U5R4inCl4pUO71F1AWKtcY9xLgHHRbfuae2Cjb2Kq2zff7YvMHeSgeMd8CgHVQb8T-8xTmGQcZA3IgDLNkjDkts9wj8cpydwL24UeawyT7RPlGjgvJnhDjjdwRMs45HEQhy4y0fSODpDAPyzZx0W7XKadYIEKZKYXpsXgwhonxyameiW_vrr5efqiuP73_ePn2uorWNrkyqh-6Fno9gDVorC1vdKht02rdDU65Gnowug1aN0bHdhy6zmF04xj70DbmTLw49t3R8nNFzr4sFHEqN-Gysm-cVQDOdYV89g95u6xUDmavug6M0jUUqD5CkRZmwtHvKG0D_fIK_F0W_pCFvzPaA_hDFt4U3fNT88AxTGOxJib-K65Vq60q2MURw2LJPiF5jgnniEOiEooflvSfQb8BK3KeCw</recordid><startdate>20001021</startdate><enddate>20001021</enddate><creator>Hannah, Mary E</creator><creator>Hannah, Walter J</creator><creator>Hewson, Sheila A</creator><creator>Hodnett, Ellen D</creator><creator>Saigal, Saroj</creator><creator>Willan, Andrew R</creator><general>Elsevier Ltd</general><general>Lancet</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TT</scope><scope>0TZ</scope><scope>0U~</scope><scope>3V.</scope><scope>7QL</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KB~</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope></search><sort><creationdate>20001021</creationdate><title>Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial</title><author>Hannah, Mary E ; Hannah, Walter J ; Hewson, Sheila A ; Hodnett, Ellen D ; Saigal, Saroj ; Willan, Andrew R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-31bd980b2d043e344344f6e2478229d61650b0328a22732c8fd996ec6ffcba873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Biological and medical sciences</topic><topic>Births</topic><topic>Cesarean section</topic><topic>Clinical trials</topic><topic>Delivery. 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Collaborative</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial</atitle><jtitle>The Lancet (British edition)</jtitle><date>2000-10-21</date><risdate>2000</risdate><volume>356</volume><issue>9239</issue><spage>1375</spage><epage>1383</epage><pages>1375-1383</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>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.
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.
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).
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.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><doi>10.1016/S0140-6736(00)02840-3</doi><tpages>9</tpages></addata></record> |
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| subjects | Biological and medical sciences Births Cesarean section Clinical trials Delivery. Postpartum. Lactation Gynecology. Andrology. Obstetrics Infant mortality Maternal mortality Medical sciences Morbidity Neonates Obstetrical techniques Pregnancy |
| title | Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial |
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