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Re: Breech Trail From: zygote@icsi.net Sun Jan 22 12:47:50 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Re: Vulvar haematoma" Previous message: GA12L@aol.com: "Hospital is a safe place to give birth..." In reply to: GA12L@aol.com: "Breech Trail" Next in thread: RModugno@aol.com: "Re: Breech Trail" The conclusion of this study was anticipated when you read the circumstances concerning where, how, who participated and multiple other factors when the study was carrried out. The reality is that in this country where C/S is the standard of care, only a fool would do vag breech. That categorical statement also includes the standard statement to patients that neurological injury occurs in ~1% of Vag Breech. Not withstanding consent, if you have a bad outcome you will be at the courthouse, or more likely end up settling out for many millions. Mom will say that she did not really expect this and the MD said it would not happen. Being one of those who likes vag breech delivery it would be nice for a change but it is not going to happen folks! Bob On 21 Jan 2006 at 11:53, GA12L@aol.com wrote: > > Hmmmm...just as I thought! > > Five years to the term breech trial: The rise and fall of a randomized controlled trial. > American Journal of Obstetrics & Gynecology. 194(1):20-25, January 2006. > Glezerman, Marek MD > Abstract: > Objective: On the basis of the end points of neonatal morbidity and death, the authors of the term > breech trial concluded unequivocally that cesarean delivery was safer for breech babies. > Study design: Analysis of the original and new data gives rise to serious concerns as far as study > design, methods, and conclusions are concerned. In a substantial number of cases, there was a > lack of adherence to the inclusion criteria. There was a large interinstitutional variation of standard > of care; inadequate methods of antepartum and intrapartum fetal assessment were used, and a > large proportion of women were recruited during active labor. In many instances of planned > vaginal delivery, there was no attendance of a clinician with adequate expertise. > Results: Most cases of neonatal death and morbidity in the term breech trial cannot be attributed > to the mode of delivery. Moreover, analysis of outcome after 2 years has shown no difference > between vaginal and abdominal deliveries of breech babies. > Conclusion: The original term breech trial recommendations should be withdrawn. > Robert J. Carpenter, Jr. MD 6624 Fannin, #2720 Houston, TX 77030 (O) 713-795-4600 (F) 713-795-4422 "Life is difficult" The Road Less Travelled by Scott Peck Next message: Anna Meenan, MD: "Re: Vulvar haematoma" Previous message: GA12L@aol.com: "Hospital is a safe place to give birth..." In reply to: GA12L@aol.com: "Breech Trail" Next in thread: RModugno@aol.com: "Re: Breech Trail"

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