Authors' objectives:

This aim of this report was to assess the most appropriate route of delivery for the preterm breech infant.

Authors' recommendations: - The optimum mode of delivery of women in preterm labour with a fetus presenting by the breech is controversial. Most of the published data and those critiqued for this report are observational and retrospective and are prone to serious biases. - Nine of the eleven studies examined for this report shared a similar objective: to determine the optimum mode of delivery - vaginal versus caesarean section - of the early preterm fetus in breech presentation. The remaining two studies include both preterm and term infants. - Four retrospective cohort studies, one incomplete randomised control trial and one comparative study indicated that the risk of neonatal death for infants with breech presentation born vaginally was significantly greater than for those born by caesarean section. - Two retrospective cohort studies from Northern Nigeria and Jordan did not advocate the routine use of caesarean section for delivering preterm breech fetuses - Three retrospective cohort studies showed no difference in neonatal mortality between those born vaginally or those born by caesarean section. - Nine of the eleven studies shared a similar outcome neonatal mortality and morbidity. Of the remaining two studies, survival rates were examined at two and five year intervals. - Three of the studies detailed neonatal mortality according to weight and disease, two according to disease and weight alone, one by delivery and one by weight and gestational age. - Seven of the studies obtained their data from the clinical environment whilst the remaining four studies extracted data from a detailed births and deaths registries.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.med.monash.edu.au/healthservices/cce/evidence/

Year Published: 2000

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Centre for Clinical Effectiveness

Contact Address: Monash Institute of Health Services Research, Block E, Monash Medical Centre, Locked Bag 29, Clayton, Victoria 3168, Australia. Tel: +61 3 9594 7505; Fax: +61 3 9594 7552.

Contact Name: cce@med.monash.edu.au.

Contact Email: cce@med.monash.edu.au.

Copyright: Centre for Clinical Effectiveness (CCE)