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Related Experiment Videos

Planned caesarean section for term breech delivery.

G J Hofmeyr1, M E Hannah

  • 1Effective Care Research Unit, University of the Witwatersrand), Frere/Cecilia Makiwane Hospitals, Private Bag 9047, East London 5200, Eastern Cape, South Africa.

The Cochrane Database of Systematic Reviews
|August 15, 2003
PubMed
Summary

Planned caesarean section for term breech presentation significantly reduces perinatal or neonatal death and serious neonatal morbidity. However, it is associated with increased short-term maternal morbidity, though some symptoms like incontinence and perineal pain improve.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Surgical Outcomes

Background:

  • Routine caesarean section for breech presentation is common, but poor outcomes may stem from underlying fetal conditions rather than delivery complications.
  • Assessing the impact of planned caesarean delivery versus vaginal birth for term breech presentation is crucial for optimizing pregnancy outcomes.

Purpose of the Study:

  • To evaluate the effects of planned caesarean section on pregnancy outcomes for singleton breech presentations at term.

Main Methods:

  • A systematic review of randomized controlled trials was conducted, searching the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Central Register of Controlled Trials.
  • Included trials compared planned caesarean section with planned vaginal birth for singleton breech presentation at term.

Related Experiment Videos

  • Trial eligibility and quality were assessed.

    • Main Results:

    • Three trials with 2396 participants were analyzed. Planned caesarean section reduced perinatal/neonatal death or serious neonatal morbidity (RR 0.33, 95% CI 0.19-0.56).
    • This risk reduction was less pronounced in countries with high national perinatal mortality rates.
    • Planned caesarean section led to modestly increased short-term maternal morbidity (RR 1.29, 95% CI 1.03-1.61), but improved outcomes for urinary and perineal incontinence at 3 months postpartum.

    Conclusions:

    • Planned caesarean section for term singleton breech presentation lowers perinatal/neonatal death and serious morbidity but increases maternal morbidity.
    • Long-term maternal consequences and the efficacy of external cephalic version require further investigation.
    • Findings are applicable to settings with readily available caesarean sections and specific clinical protocols, aiding individualized decision-making.