[Breech presentation at term: a survey on obstetrical practice in France and a search for a homogeneous attitude associated with lower neonatal risk].
OBJECTIVE
1- In order to define a "consensual attitude" in case of breech presentation, we queried the AUDIPOG network on obstetrical practice in search for the more frequently accepted criteria for normal delivery. 2- For consensual practices that could be identified, early neonatal complications were compared between women cared for in maternity wards applying these practices and those cared for in maternity wards not applying these practices.


METHODS
1- A confidential survey was sent to participating obstetrics units to determine their practical attitude in case of breech presentation. A consensual attitude was established on the basis of their responses. 2- Crude and adjusted comparisons were made concerning neonatal results between the consensual and non consensual groups of obstetrics units.


RESULTS
Response rate was 85% for 175 obstetrics departments consulted. Six criteria were identified leading to classification of 42% of the units as consensual obstetrics units. The risk of major neonatal complications was lower in the consensual group than in the non-consensual group: adjusted OR=0.27 (95% CI: 0.09-0.85).


CONCLUSIONS
A questionnaire on obstetrical practice can help define consensual attitudes associated with lower risk of neonatal complications.
Vendittelli
F
F
Département de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Grenoble, Centre Médico-Social de la femme, BP 217, 38043 Grenoble Cedex, France. FVendittelli@chu-grenoble.fr
Roche
S
S
Pons
J C
JC
Mamelle
N
N
D001291:Attitude of Health Personnel; D001946:Breech Presentation; D032921:Consensus; D036861:Delivery, Obstetric / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007226:Infant Mortality; D007229:Infant Welfare; D007231:Infant, Newborn; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome