Breech and induction. Time for evidence‐based informed consent

Guidance of women with breech presentation is a subject continuous discussion. Welle-Strand et al1 concluded that there was no significant difference for cesarean section rates or umbilical artery pH lower than 7.0 when comparing induction spontaneous delivery in their Norwegian cohort. However, the 7.0, which 2.6% and 0.8% respectively, combined measured as variable clearly shows induced cohort had clinically pH. It expected could lead to stronger contractions therefore even increased risk head entrapment. When biological plausibility other outcomes support result, it has be taken into account interpreting results. Regarding section, adjusted analyses showed 65% who underwent though confidence intervals covered effect. As also been found studies,2 seems too simplified conclude “no effect found.” A recent review admission neonatal intensive care units2 only 700 women. Hence, considerable uncertainty how affects outcomes. Of real concern rate Apgar score below 7 after 5 minutes 11% planned vaginal group compared 3% current study. The 7.05 7% delivery. This extremely high we would expect offered were carefully screened pregnancy complications associated intrauterine distress. stated by authors, randomized controlled trials3 have shown section. study heavily criticized followed observational studies arguing risks eliminated through selection. meta-analysis confirmed riskier “real-life” set-up.4 three times increase Belgian/French supposedly safety deliveries.5 question many mothers choose if they knew having baby seriously compromised Based on further this risk. Women should informed about four low general, pH, possibly particular, induction.