Document Detail


Consequences of the Term Breech Trial in Denmark.
MedLine Citation:
PMID:  21476999     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 term and 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 to neonatal 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 neonatal mortality 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 from 1.0 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.
Authors:
Julie E Hartnack Tharin; Steen Rasmussen; Lone Krebs
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-05-27
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  90     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-10     Completed Date:  2011-08-19     Revised Date:  2012-05-11    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  767-71     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Holbaek Hospital, University of Copenhagen, Copenhagen, Denmark. julie_hartnack@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Breech Presentation / surgery*,  therapy
Cesarean Section / adverse effects,  statistics & numerical data*
Clinical Trials as Topic
Cohort Studies
Denmark
Female
Follow-Up Studies
Humans
Infant Mortality / trends*
Infant, Newborn
Natural Childbirth / statistics & numerical data
Pregnancy
Pregnancy Outcome
Publications
Registries
Retrospective Studies
Risk Assessment
Safety Management
Term Birth*
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
J Obstet Gynaecol Can. 2012 Apr;34(4):318-9   [PMID:  22472329 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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