I am 10 days from my due date. My baby is in a full breech position (feet down). My son was a frank breech, delivered by c-section. We had planned to attempt vbac, but two of three of the doctors in my ob office who were very enthusiastic about the vbac now say I need a second c-section. I'm confused, and can't find good info.
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Dr David
Moderator posted 24 January 2001 06:40 PM
First, you could consider external cephalic version, or turning the baby. Most major obstetric hospitals would have an ECV clinic, or at least someone with experience or interest in this technique. A previous Caesar is a relative contra-indication to ECV, that is, it is reasonable to offer after appropriate explanation and counselling. Below are two references to ECV after previous Caesar, and the cochrane summary on ECV.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1872341&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7913053&dopt=Abstract
http://www.cochrane.de/cochrane/revabstr/ab000083.htm
What if the baby doesn't turn?
There is a small reported experience with breech VBAC.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2750812&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2795566&dopt=Abstract
The recent term breech trial, however, has provides new information about the safety of planned vaginal breech birth versus elective caesarean birth. The authors tell me that a small number of women in the trial had had a previous caesar, and that outcomes in them didn't differ from women with no previous Caesar. Can be read at the address below, along with the editorial comment. Soon, I'm sure there will an alternative view published in other journals, but their research methods seem of high quality.
http://www.thelancet.com/journal/vol356/iss9239/contents
Dr David
DISCLAIMER:
This advice is of a general nature to help in decision-making. It
does not constitute recommended treatment for an individual. You must
consult your health care provider for individual
advice
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Dr David's 2nd Response -
Moderator posted 25 January 2001 08:33 AM
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Some comments on the term breech trial can be read in this weeks Lancet. http://www.thelancet.com/journal/vol357/iss9251/full/llan.357.9251.correspondence.14964.1
Dr.David
DISCLAIMER:
This advice is of a general nature to help in decision-making. It
does not constitute recommended treatment for an individual. You must
consult your health care provider for individual
advice.