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Planned Cesarean Section Versus Planned Vaginal Birth for Breech Presentation at Term

The Term Breech Trial was an international randomized control trial to compare a policy of planned cesarean delivery versus planned vaginal delivery for the singleton term breech fetus. The primary outcome was a composite of perinatal and neonatal mortality and neonatal morbidity. Secondary outcomes were serious maternal morbidity or mortality. The odds of the primary outcome were significantly lower for the planned cesarean section group than for the planned vaginal birth group. This risk reduction was greatest at centers located in industrialized countries with overall low perinatal mortality rates. There were no significant differences in maternal outcomes. The article reviews this hallmark trial and places its findings in context within the current landscape of obstetrics.