Source | Location and Type of Study | Intervention | Stillbirths/Perinatal Outcomes |
---|---|---|---|
Reviews and meta-analyses | |||
Hofmeyr et al. 2003 [97] | USA. Meta-analysis (Cochrane). 3 RCTs included (N = 2388 women). | To assess the effects of planned Caesarean section for singleton breech presentation at term (intervention) vs. planned vaginal delivery on measures of pregnancy outcome. | PMR/NMR (excluding fatal malformations): RR = 0.29 (95% CI: 0.10–0.86). [3/1166 vs. 14/1222 in intervention and control groups, respectively]. |
Intervention studies | |||
Irion et al. 1998 [99] | Switzerland (Geneva). University hospital. Cohort study. N = 705 consecutive singleton term breech presentations (N = 385 planned vaginal deliveries, N = 320 planned Caesarean sections). | Compared the impact on neonatal mortality of planned vaginal delivery vs. elective Caesarean section in term breech presentations. | NMR (all major malformations): RR = 3.33 (95% CI: 0.37–29.60). [1% vs. 0.3% in planned vaginal vs. Caesarean groups, respectively; P = 0.38]. |
Molkenboer et al. [100] | The Netherlands. 2 centres. Retrospective matched cohort study. N = 1119 deliveries between July 1998 and April 2000 (N = 373 breech between 37(+0) and 41(+6) weeks, N = 746 cephalic position). | Compared the impact on perinatal mortality in babies with breech presentation (exposed) vs. those with cephalic presentation (unexposed). | PMR: 0 in both groups. Planned Caesarean: 23.3% vs. 3.5% in breech vs. cephalic deliveries, respectively; P < 0.001. Emergency Caesarean: 29.2% vs. 8.8% in exposed vs. unexposed groups, respectively; P < 0.001. |
Nalliah et al. 2009 [152] | Malaysia (Ipoh). Hospital based study. Retrospective analysis. N = 4886 breech presentations from 1992–2004, of which 3725 were evaluated. | Compared perinatal mortality among breech births delivered vaginally versus by Caesarean section. | PMR: Mode of delivery did not improve PMR in breech cases. |