Mar 15, 2007

Recent Studies in Support of the TBT

Several well-designed research trials have confirmed and improved upon the findings of the TBT, using better obstetric protocols and management. They are:

A 2005 study of nearly a million births in Sweden found higher rates of mortality among breech babies versus headfirst babies, as well as higher rates among breech babies delivered vaginally than those delivered by cesarean. Essentially, planned cesareans reduced the risk of mortality by half. Yet the study did admit that one third of all the deaths may have been independent of the mode of delivery, due to high prevalence of malformations. While the results were not strong enough to recommend that all twins be delivered by cesarean, nearly 90% of all singleton term breech babies already are sectioned in Sweden. Here is the Pubmed Abstract.

A 2005 study of term breech babies from the Netherlands confirms a dramatic rise in the cesarean rate and accompanying decline in perinatal mortality and birth trauma. Looking at more than 33,000 breech infants, the study noted a twofold decrease in perinatal death and a fourfold decrease in neonatal trauma in the two years following implementation of the Term Breech Trial. Within two months of the trial's publication, the cesarean rate for term breeches shot up from 50% to 80%, where it has remained since. Here is the Pubmed Abstract.

A retrospective study from California looked at over 100 ,000 term breech babies born over a decade. It concluded that full-term singleton breech babies delivered vaginally had much higher rates of mortality and morbidity than babies those delivered by planned cesarean. However, more than 95% of the breech babies were delivered by cesarean, suggesting a very low threshold of tolerance (or skill?) for vaginal delivery. Here is the
full article.

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