title: Assisted vaginal delivery versus caesarean section in breech presentation.
abstract: BACKGROUND
  The Term Breech Trial (TBT), a well-known study conducted by Hannah and published in the Lancet, revealed a better outcome for neonates after primary caesarean section compared with attempted vaginal delivery. The aim of the present study was to determine whether the results of TBT have to be taken into account when counseling pregnant women in central Europe.
  
  
  METHODS
  We investigated 882 women who had delivered infants in breech presentation over a period of 11 years. The neonates had a birthweight of >2500 g and no malformations. We compared mortality and serious neonatal morbidity after attempted vaginal delivery and after primary caesarean section.
  
  
  RESULTS
  No infant or maternal mortality was registered in either group. Serious neonatal morbidity was higher (0.5%; n = 2) for attempted vaginal delivery than for primary caesarean section; in the latter group, no child fulfilled the criteria for serious neonatal morbidity. However, the difference was not statistically significant. As expected, after attempted vaginal delivery, the base excess, and 5-min APGAR scores were indicative of more markedly depressed children.
  
  
  CONCLUSIONS
  After careful exclusion of risk factors and informing the patient in detail about the risks and possible complications, vaginal delivery from breech presentation is still warrantable.
authors.affiliation: Landes-Frauen- und Kinderklinik, Abteilung für Geburtshilfe, Linz, Austria. hartmut.krupitz@gespag.at
authors.forename: Hartmut
authors.initials: H
authors.lastname: Krupitz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Arzt
authors.forename: Thomas
authors.initials: T
authors.lastname: Ebner
authors.forename: Michael
authors.initials: M
authors.lastname: Sommergruber
authors.forename: Erwin
authors.initials: E
authors.lastname: Steininger
authors.forename: Gernot
authors.initials: G
authors.lastname: Tews
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D001946:Breech Presentation; D002585:Cesarean Section / Q000379:methods / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008499:Medical Records; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies