Fiche publication
Date publication
novembre 2013
Auteurs
Membres identifiés du Cancéropôle Est :
Pr RAMANAH Rajeev
Tous les auteurs :
Gannard-Pechin E, Ramanah R, Desmarets M, Maillet R, Riethmuller D
Lien Pubmed
Résumé
AIMS: The obstetrical management of term breech presentations in singleton pregnancies usually opposes the advocates of elective caesarean section to vaginal birth. Twelve years after the Term Breech Trial and 6 years after the PREMODA study, the aims of this work are to analyze neonatal results according to route of delivery chosen before labour and to evaluate professional practices in an important continuous series of cases. PATIENTS AND METHODS: This is a retrospective study including all breech singleton pregnancies that delivered at our level III labour ward at 37 weeks of amenorrhea, from 1st January 2005 to 31st December 2011. All data were analyzed in intention to treat. RESULTS: Of the 418 patients included during the study period, 52% of them delivered vaginally. In 81% of cases, a vaginal birth trial was accepted and 64% of these patients delivered vaginally. Severe morbidity and neonatal mortality judgement criteria were not significantly different between the vaginal birth trial and the elective caesarean groups. Our obstetrical department continues to provide residents with specific training in the management of breech presentations. In this study, 60% of breech deliveries were performed by residents. CONCLUSION: Although a limited statistical power, this study did not bring any proof in favour of elective caesarean for singleton term breech presentations. Training residents in the management of vaginal breech deliveries is feasible and highly recommended.
Référence
J Gynecol Obstet Biol Reprod (Paris). 2013 Nov;42(7):685-92
