title: Outcomes at 3 months after planned cesarean vs planned vaginal delivery for breech presentation at term: the international randomized Term Breech Trial.
abstract: BACKGROUND
  The Term Breech Trial found a significant reduction in adverse perinatal outcomes without an increased risk of immediate maternal morbidity with planned cesarean delivery compared with planned vaginal birth. No randomized controlled trial of planned cesarean delivery has measured benefits and risks of postpartum outcomes months after the birth.
  
  
  OBJECTIVE
  To compare maternal outcomes of planned cesarean delivery and planned vaginal birth at 3 months post partum.
  
  
  METHODS
  Follow-up study to the Term Breech Trial, a randomized controlled trial conducted between January 9, 1997, and April 21, 2000.
  
  
  METHODS
  A total of 1596 of 1940 women from 110 centers worldwide who had a singleton fetus in breech presentation at term responded to a follow-up questionnaire at 3 months post partum.
  
  
  METHODS
  Breastfeeding; infant health; ease of caring for infant and adjusting to being a new mother; sexual relations and relationship with husband/partner; pain; urinary, flatal, and fecal incontinence; depression; and views regarding childbirth experience and study participation.
  
  
  RESULTS
  Baseline information was similar for both the cesarean and vaginal delivery groups. Women in the planned cesarean delivery group were less likely to report urinary incontinence than those in the planned vaginal birth group (36/798 [4.5%] vs 58/797 [7.3%]; relative risk, 0.62; 95% confidence interval, 0.41-0.93). Incontinence of flatus was not different between groups but was less of a problem in the planned cesarean delivery group when it occurred (P =.006). There were no differences between groups in other outcomes.
  
  
  CONCLUSIONS
  Planned cesarean delivery for pregnancies with breech presentation at term may result in a lower risk of incontinence and is not associated with an increased risk of other problems for women at 3 months post partum, although the effect on longer-term outcomes is uncertain.
authors.affiliation: Department of Obstetrics and Gynaecology, Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. mary.hannah@utoronto.ca
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hannah
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Hannah
authors.forename: Ellen D
authors.initials: ED
authors.lastname: Hodnett
authors.forename: Beverley
authors.initials: B
authors.lastname: Chalmers
authors.forename: Rose
authors.initials: R
authors.lastname: Kung
authors.forename: Andrew
authors.initials: A
authors.lastname: Willan
authors.forename: Kofi
authors.initials: K
authors.lastname: Amankwah
authors.forename: Mary
authors.initials: M
authors.lastname: Cheng
authors.forename: Michael
authors.initials: M
authors.lastname: Helewa
authors.forename: Sheila
authors.initials: S
authors.lastname: Hewson
authors.forename: Saroj
authors.initials: S
authors.lastname: Saigal
authors.forename: Hilary
authors.initials: H
authors.lastname: Whyte
authors.forename: Amiram
authors.initials: A
authors.lastname: Gafni
mesh_terms: D001942:Breast Feeding; D001946:Breech Presentation; D002585:Cesarean Section; D036861:Delivery, Obstetric; D003863:Depression; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008425:Maternal Behavior; D009034:Mother-Child Relations; D010146:Pain; D017060:Patient Satisfaction; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology*; D012725:Sexual Behavior; D016896:Treatment Outcome; D014549:Urinary Incontinence