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Cesarean or vaginal delivery for the breech fetus at the threshold of viability: results from a maternal?fetal medicine specialists survey.
MedLine Citation:
PMID:  20807158     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective.?To determine how United States Maternal?Fetal medicine specialists recommend delivery of a breech fetus at the threshold of viability. Methods.?U.S. Society for Maternal?Fetal Medicine (SMFM) members were surveyed about; geographic location, practice type, whether they performed deliveries, definition of threshold for viability, recommendations for delivery of a breech fetus at the threshold of viability, and if the current medical?legal climate had any bearing on their decisions. Chi-Square and Fisher's Exact tests were used for analysis. Results.?510 SMFM members responded to the questionnaire. The highest percentage of respondents stated ?23 weeks? (31%) as the cutoff for viability, followed by ?24 weeks? (21%) and ?23 weeks or 500 g? (10%). Seventy percent recommended cesarean delivery for a breech fetus at the threshold of viability. The majority of respondents based their decision on ?published data? or ?expert opinion?, however, 58.6% reported they felt current medical evidence was inadequate to support a recommendation. Fifty-three percent stated their recommendations are affected by medical?legal concerns. Conclusion.?The majority of U.S. maternal fetal?medicine specialists who responded would recommend cesarean delivery for a breech fetus at the threshold of viability, despite the belief that there is inadequate evidence in the literature to support this recommendation.
Authors:
Aaron B Deutsch; Karen Duncan; Lakshminarayan Rajaram; Hamisu M Salihu; William N Spellacy; Victoria Belogolovkin
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Publication Detail:
Type:  Journal Article     Date:  2010-09-01
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  24     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  475-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida College of Medicine, Tampa, FL, USA.
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