-
Regarding term breech delivery, it is correct to affirm that:
-
Its incidence is 0.5% of pregnancies to term.
-
It is the fifth most common presentation.
-
Nulliparity is an associated factor.
-
The complete presentation is the most common.
-
-
The term breech trial (TBT), which compared the elective cesarean section with planned vaginal delivery, found:
-
Reduced risk of neonatal hypotonia with cesarean delivery.
-
Increased risk of neonatal seizures with cesarean delivery.
-
Increased perinatal morbidity and mortality with vaginal delivery.
-
Reduced perinatal morbidity and mortality with cesarean delivery.
-
-
In maternal morbidity and mortality, comparing the elective cesarean section with planned vaginal delivery, it can be said that:
-
There is a significant increase in maternal mortality with vaginal delivery.
-
There is a significant increase in maternal morbidity with cesarean delivery.
-
There is a reduction of maternal morbidity and mortality with cesarean delivery.
-
Results are controversial.
-
-
Regarding neonatal morbidity and mortality, comparing the elective cesarean section with planned vaginal delivery, it can be said that:
-
There is a significant reduction of maternal mortality with vaginal delivery.
-
Results are controversial.
-
There is a significant reduction of maternal morbidity with cesarean delivery.
-
There is an increase in maternal morbidity and mortality with cesarean delivery.
-
-
What is the recommendation for the mode of delivery in patients with a TBT?
-
Planned vaginal delivery is recommended, in selected cases, and under ideal conditions (professionals experienced in maneuvers for breech presentation).
-
Cesarean delivery is mandatory in all cases.
-
Planned vaginal delivery may be indicated provided that a C-section is contraindicated.
-
There is no specific recommendation and the procedure is at the discretion of the obstetrician.
-
Answers to clinical scenario: update on cesarean on request [published in RAMB 2015; 61(4)]
-
What is the correct approach to maternal request for cesarean section?
Know with greater emphasis personal values and preferences of the mother and approach them in a process of shared decision (Alternative A).
-
Does cesarean section on maternal request or with no indication increase the risk of bleeding complications?
Yes, it increases the absolute risk of bleeding complications with statistical significance (Alternative A).
-
Does cesarean section on maternal request or with no indication increase the risk of infectious complications?
Yes, it increases the absolute risk of infectious complications with statistical significance (Alternative A).
-
Does cesarean section on maternal request or with no indication increase the risk of which outcomes?
Hemorrhagic, infectious and breastfeeding complications, and respiratory complications for the newborn (Alternative A).
-
What is the period when the cesarean section should be done in case of vaginal delivery refusal?
After week 39 (Alternative A).
Publication Dates
-
Publication in this collection
Sep-Oct 2015