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    Vaginal or caesarean delivery? How research has turned breech birth around

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    Authors
    Steen, Mary
    Kingdon, Carol
    Affiliation
    RCM/UCLan ; UCLan
    Publication Date
    2008-09
    
    Metadata
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    Abstract
    Background: Breech presentation, where a baby is buttocks or feet first rather than head occurs in about 3 to 4% of singleton pregnancies at term. Worldwide, the vast majority of babies identified as breech are now delivered by planned caesarean section. Aim: to identify relevant published research evidence relating to vaginal and caesarean breech birth and then to discuss the evidence, subsequent controversy and clinical implications that have influence an ongoing obstetrical debate. Method: A structured literature review was undertaken using the Cochrane Library, CINAHL, EMBASE and MEDLINE databases. Different permutations of 'breech' ('frank' or 'complete' or 'extended' or 'flexed') and 'vaginal' or 'caesarean' ('cesarean' or 'cesarian' or 'caesarean') and 'term' and 'singleton' in the title, key words or abstracts were the terms used. Results: Over the last 50 years, there has been an increasing trend toward the routine use of caesarean section as a preventive way of reducing the poor outcomes associated with breech presentation. Research evidence has also played a pivotal role in influencing the routine use of caesarean breech birth and, in particular, a single research trial, the Term Breech Trial (TBT) has substantially influenced current policy and practice. There is no other area of research that has such an impact upon clinical practice in such a short period of time. Conclusions: The speed and extent to which the recommendations of the TBT were implemented has given rise to new controversy surrounding the safety of breech birth, while raising important questions about how the findings of research are used in practice.
    Citation
    Evidence Based Midwifery, 2008, 6(3), pp. 95-99
    Publisher
    T G Scott
    Journal
    Evidence Based Midwifery
    URI
    http://hdl.handle.net/10034/48248
    Additional Links
    http://www.rcm.org.uk/magazines/ebm/
    Type
    Article
    Language
    en
    Description
    This article is not available through ChesterRep.
    ISSN
    1479-4489
    Collections
    Health and Social Care

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