Document Detail

A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant.
MedLine Citation:
PMID:  25488088     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVE: To determine the optimum mode of delivery for women in preterm breech labour at a gestational age of 26 to 32 weeks.
DESIGN: A multicentre randomised controlled trial.
SETTING: Twenty-six hospitals in England, UK.
PARTICIPANTS: Women with a singleton breech fetus in spontaneous preterm labour between 26 and 32 completed weeks of gestation, with no clear indication for a caesarean section or vaginal breech delivery.
INTERVENTION: Random allocation to either 'intention to delivery vaginally' or 'intention to deliver by caesarean section'.
MAIN OUTCOME MEASURES: Perinatal mortality, neonatal morbidity, maternal morbidity and gestation at delivery.
RESULTS: The trial was closed after 17 months because of low recruitment, by which time substantial numbers of women had been in the eligible gestation period. Thirteen women from six hospitals were recruited. One infant, randomised to and delivered vaginally, was stillborn. Three fetal presentations were cephalic at delivery despite a diagnosis of breech presentation at trial entry. No formal statistical analysis was performed due to the small numbers.
CONCLUSIONS: No conclusions about the optimum mode of delivery for women in preterm labour with a fetus presenting by the breech can be drawn from this trial. The low accrual rate was due to clinicians' reluctance to randomise eligible women, reflecting the circumstances and nature of the trial.
Zoe J Penn; Philip J Steer; Adrian Grant
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJOG : an international journal of obstetrics and gynaecology     Volume:  121 Suppl 7     ISSN:  1471-0528     ISO Abbreviation:  BJOG     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100935741     Medline TA:  BJOG     Country:  England    
Other Details:
Languages:  eng     Pagination:  48-53     Citation Subset:  AIM; IM    
Copyright Information:
© RCOG 1996 British Journal of Obstetrics and Gynaecology.
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