Management of preterm delivery in women with abnormal fetal presentation

The aim of the thesis was to answer the following questions.
1. What is the optimal mode of delivery in preterm breech presentation?
2. Does an intended caesarean section reduce the risk of perinatal mortality and morbidity as compared to intended vaginal delivery in preterm breech presentation?
3. What is the effect of the mode of delivery in preterm breech presentation on perinatal and maternal outcomes in the subsequent pregnancy?
4. What is the effect of the increased elective caesarean delivery rates for term breech presentation on maternal and neonatal outcome?
5. Does a planned caesarean section improve perinatal outcome in women with twin pregnancy and a very preterm delivery as compared to planned vaginal delivery?
6. Does a caesarean section reduce the risk of adverse perinatal outcomes in women with a triplet pregnancy?
For the majority of the studies described in this thesis we were allowed to use the data of the Netherlands Perinatal Registry (PRN). The PRN consists of population-based data containing information on pregnancies, deliveries and (re)admissions until 28 days after birth. The coverage of the PRN registry is about 96% of all deliveries in the Netherlands.
Part I reports on studies concerning neonatal and maternal outcome related to the mode of delivery in (pre)term breech presentation.
Part II contains studies that report on neonatal and maternal outcome related to the mode of delivery in preterm delivery of multiple pregnancies.