Re: Breech Trail

From: Bernard Cristalli (bcrist@club-internet.fr)
Wed Jan 25 10:16:44 2006


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Eberhard, How were those patient allocated to this VD protocol? How queer mortality "reduction was less for countries with high national perinatal mortality rates", does it mean that perinatal care was THE point? And "At two years, there were no differences in the combined outcome 'death or neurodevelopmental delay'. Maternal outcomes at 2 years were also similar." So this review is not that clear. B

Dr Eberhard Lisse wrote:

>Actually,
>
>it has not beeen *PROVED* or *PROVEN* for this matter, there was just
>one opinion.
>
>And you should probably *READ* the Cochrane review:
>
>Three trials (2396 participants) were included in the review. Caesarean
>delivery occurred in 550/1227 (45%) of those women allocated to a
>vaginal delivery protocol. Perinatal or neonatal death (excluding fatal
>anomalies) or serious neonatal morbidity was reduced with planned
>caesarean section (relative risk (RR) 0.33, 95% confidence interval (CI)
>0.19 to 0.56). This reduction was less for countries with high national
>perinatal mortality rates. Perinatal or neonatal death (excluding fatal
>anomalies) was also reduced with planned caesarean section (RR 0.29, 95%
>CI 0.10 to 0.86). The proportional reductions were similar for countries
>with low and high national perinatal mortality rates. Planned caesarean
>section was associated with modestly increased short-term maternal
>morbidity (RR 1.29, 95% CI 1.03 to 1.61). At three months after
>delivery, women allocated to the planned caesarean section group
>reported less urinary incontinence (RR 0.62, 95% CI 0.41 to 0.93); more
>abdominal pain (RR 1.89, 95% CI 1.29 to 2. 79); and less perineal pain
>(RR 0.32, 95% CI 0.18 to 0.58).At two years, there were no differences
>in the combined outcome 'death or neurodevelopmental delay'. Maternal
>outcomes at 2 years were also similar.
>
>That means the surviors!
>
>on 1/24/06 5:21 PM Bernard Cristalli said the following:
>
>>Yes.
>>The recent Hannah trial has been proved to be biased and the 2 year
>>outcome of mothers and children has been found to be equivalent in both
>>groups vaginal and cesarean, to begin with.
>>BC
>>
>>Dr Eberhard Lisse a écrit :
>>
>>>Can you prove yours?
>>>
>>>el
>>>
>





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