Related Experiment Videos
Recent trends in breech delivery in the Netherlands
Jan F M Molkenboer1, Peter X J M Bouckaert, Frans J M E Roumen
1Atrium Medical Centre, Heerlen, The Netherlands.
BJOG : an International Journal of Obstetrics and Gynaecology
|October 11, 2003
Summary
Publication of the Term Breech Trial results in 2000 rapidly increased caesarean section rates for breech presentation births in the Netherlands. This trend amplified existing changes, influenced by scientific and legal factors.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Clinical Trial Analysis
Background:
- The Term Breech Trial (TBT) published in 2000 significantly impacted clinical practice regarding breech presentation delivery.
- Prior to the TBT, caesarean section rates for term singleton breech presentations were already increasing in the Netherlands.
- Understanding the factors influencing rapid adoption of clinical trial results is crucial for evidence-based medicine.
Purpose of the Study:
- To evaluate the effect of the Term Breech Trial publication on the mode of delivery for breech presentation in the Netherlands.
- To analyze the immediate impact on caesarean section rates following the TBT publication.
- To explore the reasons behind the rapid adoption of TBT conclusions by Dutch obstetricians.
Main Methods:
- Retrospective analysis of delivery modes for breech presentations in the Netherlands before and after October 2000.
- Comparison of trends in caesarean section rates for term singleton breech, non-term breech, and multiple gestation breech presentations.
- Qualitative assessment of influencing factors (scientific, legal, psychological, emotional) on obstetrician decision-making.
Main Results:
- Publication of the TBT results led to an immediate and amplified increase in caesarean section rates for term singleton breech presentations.
- The observed increase in caesarean sections extended to non-term breeches and breeches from multiple gestations.
- No significant impact on delivery modes was observed for babies in non-breech presentations.
Conclusions:
- The Term Breech Trial publication had a profound and rapid effect on obstetric practice in the Netherlands, significantly increasing caesarean delivery rates for breech presentations.
- The swift adoption of TBT findings was influenced by a confluence of scientific, legal, and psychosocial factors.
- Clinical trial results can rapidly alter delivery practices, necessitating careful consideration of evidence and potential impacts on maternal and infant outcomes.