Term breech singletons and caesarean section: a population study, Australia 1991-2005

Area of Science:

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

Background:

• Term breech singleton presentation historically offered multiple delivery options.
• The management of term breech presentation has evolved significantly over time.
• Understanding trends in delivery methods for breech presentation is crucial for optimizing maternal and infant outcomes.

Purpose of the Study:

• To describe the changing methods of birth for term breech singletons in Australia.
• To analyze trends in vaginal breech birth versus caesarean section for term breech singletons.
• To assess the impact of breech presentation on overall caesarean section rates.

Main Methods:

• Retrospective population-based study utilizing the National Perinatal Data Collection.
• Analysis of data from women who gave birth to term breech singletons between 1991 and 2005.
• Examination of caesarean section and vaginal breech birth as primary outcomes.

Main Results:

• A significant decline in vaginal breech birth rates occurred from 23.1% in 1991 to 3.7% in 2005.
• Caesarean section rates for term breech singletons increased substantially, particularly for non-labour births.
• The contribution of term breech singletons to the overall caesarean section rate decreased over the study period.

Conclusions:

• Planned caesarean section has become the predominant method for term breech singleton births in Australia.
• Promoting interventions like external cephalic version is recommended to decrease caesarean section rates.
• Maintaining a skilled clinical workforce is vital for supporting vaginal breech births and related interventions.