Planned caesarean section for term breech delivery

Cochrane Review by Hofmeyr GJ, Hannah ME

This record should be cited as: Hofmeyr GJ, Hannah ME. Planned caesarean section for term breech delivery. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD000166. DOI: 10.1002/14651858.CD000166.

ABSTRACT

Title

Planned caesarean section for term breech delivery

Background

Poor outcomes after breech birth might be the result of underlying conditions causing breech presentation or to factors associated with the delivery.

Objectives

To assess the effects of planned caesarean section for singleton breech presentation at term on measures of pregnancy outcome.

Search strategy

We searched the Cochrane Pregnancy and Childbirth Group trials register (October 2004) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2004).

Selection criteria

Randomised trials comparing planned caesarean section for singleton breech presentation at term with planned vaginal birth.

Data collection and analysis

We assessed trial eligibility and quality. We extracted and analysed data using routine Cochrane Collaboration methodology.

Main results

Three trials (2396 participants) were included in the review.

Authors' conclusions

Planned caesarean section compared with planned vaginal birth reduced perinatal or neonatal death or serious neonatal morbidity, at the expense of somewhat increased maternal morbidity. The option of external cephalic version is dealt with in separate reviews. The data from this review cannot be generalised to settings where caesarean section is not readily available, or to methods of breech delivery that differ materially from the clinical delivery protocols used in the trials reviewed. The review will help to inform individualised decision-making regarding breech delivery. Research on strategies to improve the safety of breech delivery is needed.

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