Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC
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J Obstet Gynaecol Can · Oct 2002
Use of external cephalic version for breech pregnancy and mode of delivery for breech and twin pregnancy: a survey of Canadian practitioners.
(1) To understand how external cephalic version (ECV) is used in the management of breech pregnancies; (2) to determine if Canadian practitioners have changed their recommendations regarding the mode of breech delivery since becoming aware of the findings of the Term Breech Trial; and (3) to establish a baseline of how twins are being delivered in Canada. ⋯ Although the use of ECV is high in Canada, the success rate is low. Increasing the use of tocolytics, considering epidural analgesic, and repeating the procedure when the initial attempt fails may increase success and decrease Caesarean section rates. The survey results reflect a dramatic shift toward recommending Caesarean section for management of term breech pregnancies. Vaginal birth is the method of delivery of choice for most twin pregnancies of 32 weeks' gestation, especially for vertex/vertex presentations.
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In November 2002, the Royal Commission on the Future of Health Care in Canada, headed by Mr. Roy J. ⋯ Romanow concrete ideas and proposed actions to improve the health of Canadian women and their families, and to sustain and strengthen Canada's publicly funded health care system, in its report Ensuring Women's Health: Options for the Future of Canada's Health Care System. This Commentary brings to you the thoughts that the SOGC will continue to forward after the Romanow Commission's report is delivered next month.