Avoid labor augmentation in breech deliveries if a Cesarean delivery is impossible. (Term Breech Trial).

SAN FRANCISCO--If a breech fetus cannot be delivered by Cesarean section before ,the onset of labor, there are still some strategies that can be used to decrease the risk of perinatal complications, Dr. Mm Su said at the annual meeting of the Society for Maternal-Fetal Medicine.

Secondary analysis of the 1,889-patient Term Breech Trial found that avoiding labor. induction and a long active phase of the second stage of labor, as well as involvement of an obstetrician experienced in breech deliveries, reduced the risk of perinatal problems, said Dr. Su of the University of Toronto.

The primary results of the Term Breech Trial showed that a policy of planned C-section delivery of term breech fetuses was safer for babies than plannedvaginal delivery. Perinatal problems occurred in 2% after planned C-section and 5% after vaginal delivery (Lancet 356:1375-1383, 2000).

The current analysis looked at baseline antepartum characteristics and intrapartum events in 1,384 patients who delivered after some form of labor to determine which factors were associated with an increased risk for an adverse perinatal outcome.

Compared with vaginal birth, which conferred the highest risk, C-section before labor reduced the risk by 90%, and C-section during early labor reduced the risk by 80%. A 40% reduction in risk with C-section during active labor was not statistically significant.

Babies weighing less than 2,800 g were nearly twice as ...