Term Breech Trial

Question 1

What was the aim of the Term Breech Trial?

Answer 1

To determine whether planned CS was better than planned vaginal birth for selected fetsuses in the breech presentation at term

Question 2

How many women were recruited into the Term Breech Trial?

Answer 2

2088 women

Question 3

What were the inclusion criteria of the Term Breech Trial?

Answer 3

Singleton
Frank / complete breech
Term, 37+0/40

Question 4

What were the exclusion criteria of the Term Breech Trial

Answer 4

EFW > 4kg or clinically large
Fetopelvic disproportion
Hyper extension of fetal head
Fetal anomaly or condition that might cause mechanical problem
Contraindication to labour / vaginal delivery
Lethal fetal congenital anomaly

Question 5

What were the two intervention groups in the Term Breech Trial?

Answer 5

• CS at 38/40

- Vaginal birth, with IA / CEFM, augmentation with Syntocinon if required

Question 6

What were the primary outcomes of the Term Breech Trial?

Answer 6

Perinatal mortality, neonatal mortality or serious neonatal morbidity
Maternal mortality or serious maternal morbidity

Question 7

What % of those randomised to CS in the TBT had a CS?

Answer 7

90%

Question 8

What % of those randomised to vaginal delivery in the TBT had a VD?

Answer 8

57%

Reasons for CS

• FTP: 50%
• abnormal CTG: 30%
• footling breech: 15%

Question 9

What the impact of El LSCS on the primary outcome of perinatal mortality, neonatal mortality or serious neonatal morbidity

Answer 9

Decrease
1.6% vs 5% in VD group
RR 0.33
Statistically significant

NNT 14

Effect still present when excluding IOL, augmented labour and prolonged labour

Question 10

What was the effect of El LSCS on maternal mortality or serious morbidity?

Answer 10

NO difference

But doesn’t take into account following pregnancies etc.