Consequences of the term breech trial in Denmark

Julie E. Hartnack Tharin, Steen Rasmussen, Lone Krebs

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

Objective. To analyze the consequences of the handling of breech presentation in Denmark after publication of the Term Breech Trial (TBT). Design. Population-based retrospective cohort study. Settings. Data from the National Birth Registry and discharge letters from cases with perinatal death. Population. Singleton breech fetuses at termand alive at onset of labor delivered between 1997 and 2008 (n=23 789). Methods. Outcomes before and after publication of TBT were compared and analyzed by planned mode of delivery. Main outcome measures. Cesarean section, intrapartum or early neonatal mortality in infants without lethal congenital malformations, Apgar score ≤6 at five minutes and admittance toneonatal intensive care unit (NICU) for four days or more. Results. The rate of cesarean section increased from 79.6 to 94.2%. Intrapartum or early neonatalmortality was reduced from 0.13 to 0.05% [relative risk (RR) 0.38 (95% confidence intervals (CI) 0.15-0.98)]. The incidence of low Apgar scores declined from1.0 to 0.6% [RR 0.83 (95%CI 0.73-0.95)] and admission to NICU from 4.2 to 3.2% [RR 0.92 (95%CI 0.87-0.97)]. Planned vaginal delivery was associated with an increased risk of mortality, low Apgar score and admission to NICU throughout the period. Conclusion. Reduction in the rate of vaginal delivery was correlated with a significant reduction in rates of intrapartum or early neonatal mortality and morbidity, but at a much lower level than reported in the Term Breech Trial. The lower rate of vaginal delivery, indicating a strict selection of women, did not reduce the relative risks of complications during a planned vaginal delivery.

OriginalsprogEngelsk
Sider (fra-til)767-771
Antal sider5
TidsskriftActa Obstetricia et Gynecologica Scandinavica
Vol/bind90
Udgave nummer7
DOI
StatusUdgivet - 1 jul. 2011

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