Impact of the International Term Breech Trial on Clinical Practice and Concerns: A Survey of Centre Collaborators

OBJECTIVE: The purpose of this study was to determine what impact the International Term Breech Trial had had in different settings and to elicit any concerns among collaborators regarding the implementation of a policy of planned Caesarean section for term breech babies. METHODS: We mailed a questionnaire to all Term Breech Trial collaborators. The questionnaire asked 3 open-ended questions about the impact of the trial, about concerns with implementing planned Caesarean section for term breech babies, and about whether information as to the relative costs of planned Caesarean section versus planned vaginal birth would be helpful. Frequencies of responses were calculated for centres in countries classified as having a low or a high national perinatal mortality rate (< or = 20/1000 vs. > 20/1000, respectively) according to the figures published by the World Health Organization in 1996. RESULTS: We received responses from 80 centres in 23 countries. Most centres (92.5%) stated that clinical practice had changed to planned Caesarean section for most or all term breech babies. The majority of centres (66.3%) had no difficulties or concerns with implementing a policy of planned Caesarean section for term breech babies. Most centres (85.0%) indicated that an analysis of relative costs would not affect clinical practice in their setting. CONCLUSION: Clinical practice has changed to planned Caesarean section in most collaborating centres, given the results of the Term Breech Trial.