Breech delivery before and after the term breech trial recommendation

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Perinatal Outcomes

Background:

• The Term Breech Trial (TBT) significantly influenced clinical practice regarding term breech presentations.
• Understanding the impact of the TBT recommendation on delivery outcomes is crucial for optimizing obstetric care.

Purpose of the Study:

• To compare the outcomes of term breech deliveries before and after the TBT recommendation.
• To evaluate changes in cesarean section rates and neonatal outcomes post-TBT.

Main Methods:

• Retrospective study of 796 women with term breech presentation at Abha Maternity Hospital.
• Comparison of two groups: 4 years before (Group 1) and 4 years after (Group 2) the TBT recommendation.

Main Results:

• Cesarean section rates significantly increased after the TBT recommendation (p<0.05).
• Assisted vaginal delivery rates decreased significantly post-TBT (26.9% vs 17.1%, p<0.05).
• No significant differences were observed in perinatal mortality, low Apgar scores, or delivery complications between the groups (p>0.05).

Conclusions:

• The TBT recommendation resulted in a substantial rise in cesarean sections for term breech deliveries without concurrent improvement in neonatal outcomes.
• A need exists to develop policies to decrease cesarean rates, particularly for unbooked breech presentations.