Delivery of breech babies: new data.The international study widely known as the Term Breech breech (brech) the buttocks. breech n. The lower rear portion of the human trunk; the buttocks. breech, britch the buttocks of an animal; the backs of the thighs. Trial was published in October 2000 (1) and resulted in a call for all babies known to be in the breech position Breech position When a child is oriented feet first in the mother's uterus just before delivery. Mentioned in: Antenatal Testing at term to be delivered by Caesarean section (CS). This caused dissension at the time among many midwives and others, who felt that there were flaws in the conclusions drawn, that CS rates would rise unjustifiably and that skills of supporting vaginal breech births would be lost. Five years on, a 'Clinical opinion' feature in the American Journal of Obstetrics & Gynecology (2) says: 'On the basis of the end points of neonatal morbidity and death, the authors of the term breech trial concluded unequivocally that cesarean cesarean /ce·sar·e·an/ (se-zar´e-an) see under section. ce·sar·e·an or cae·sar·e·an or cae·sar·i·an or ce·sar·i·an adj. Of or relating to a cesarean section. delivery was safer for breech babies. 'Analysis of the original and new data gives rise to serious concerns as far as study design, methods and conclusions are concerned. In a substantial number of cases, there was a lack of adherence to the inclusion criteria. There was a large interinstitutional variation of standard of care; inadequate methods of antepartum antepartum /an·te·par·tum/ (-pahr´tum) occurring before parturition, or childbirth, with reference to the mother. an·te·par·tum adj. Of or occurring in the period before childbirth. and intrapartum fetal assessment were used, and a large proportion of women were recruited during active labor. In many instances of planned vaginal delivery, there was no attendance of a clinician with adequate expertise. 'Most cases of neonatal death and morbidity in the term breech trial cannot be attributed to the mode of delivery. Moreover, analysis of outcome after 2 years has shown no difference between vaginal and abdominal deliveries of breech babies. 'Conclusion--The original term breech trial recommendations should be withdrawn.' 1. Hannah ME, Hannah W J, Hewson SA et al. (The Term Breech Trial Collaborative Group). 2000. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised Adj. 1. randomised - set up or distributed in a deliberately random way randomized irregular - contrary to rule or accepted order or general practice; "irregular hiring practices" multicentre trial. The Lancet 2000; 356: 1375-1383. 2. Glezerman M. Five years to the term breech trial: The rise and fall of a randomized controlled trial A randomized controlled trial (RCT) is a scientific procedure most commonly used in testing medicines or medical procedures. RCTs are considered the most reliable form of scientific evidence because it eliminates all forms of spurious causality. . American Journal of Obstetrics and Gynecology obstetrics and gynecology Medical and surgical specialty concerned with the management of pregnancy and childbirth and with the health of the female reproductive system. 2006; 194: 20-25. |
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