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Re: Breech Trail From: art fougner, md (evsono@pipeline.com) Sun Jan 22 14:30:15 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Bernard Cristalli: "Re: Breech Trail" Previous message: RModugno@aol.com: "Re: Breech Trail" In reply to: GA12L@aol.com: "Breech Trail" Next in thread: GA12L@aol.com: "Re: Breech Trail" The only real Breech trials in the US currently involve alleged malpractice and occur in civil court. Vaginal breech delivery, mid-forceps rotation and internal version and extraction are skills which have all suffered demise secondary to disuse atrophy. Art At Sat, 21 Jan 2006, 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withdrawn. -- art fougner, md "I knew I was going to take the wrong train, so I left early." Lawrence Peter Berra Next message: Bernard Cristalli: "Re: Breech Trail" Previous message: RModugno@aol.com: "Re: Breech Trail" In reply to: GA12L@aol.com: "Breech Trail" Next in thread: GA12L@aol.com: "Re: Breech Trail"

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