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Vaginal delivery compared with caesarean section in early preterm breech delivery: a comparison of long term outcome
Author(s) -
Wolf Hans,
Schaap Arty H. P.,
Bruinse Hein W.,
Smoldersde Haas Hetty,
Ertbruggen Ingrid,
Treffers Pieter E.
Publication year - 1999
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1999.tb08303.x
Subject(s) - breech delivery , caesarean section , vaginal delivery , medicine , obstetrics , term (time) , breech presentation , outcome (game theory) , section (typography) , pregnancy , physics , computer science , mathematics , genetics , biology , mathematical economics , quantum mechanics , operating system
Objective To determine the optimum mode of delivery of the early preterm fetus in breech presentation. Design Retrospective comparison of two cohorts of preterm breech fetus. Setting Two tertiary care centres: at one centre the preferred management for preterm breech presentation was vaginal delivery; at the other centre, the preferred method was caesarean section. Population All singleton infants delivered after breech presentation from 1984 through 1989, at a gestational age of 26 to 31 weeks. Those with lethal congenital abnormalities, placenta praevia, placental abruption, fetal death or fetal distress before the onset of labour were excluded. Main outcome measures Survival without disability or handicap documented at two years corrected age. The influence of a number of relevant variables on this outcome was assessed by logistic regression analysis. Results There was no difference in survival without disability or handicap between the centres (odds ratio 1.5, 95% CI 0.6–3.9 vaginal delivery compared with caesarean section). Survival without disability or handicap was positively influenced by increasing birthweight and corticosteroids > 24 h before birth, and negatively influenced by footling presentation. Conclusion A policy of caesarean section for early preterm (26–31 weeks) breech delivery is not associated with increased survival without disability or handicap.