Discourse on the Mother's Decision Regarding the Mode of Delivery in Cases of Breech Presentation (DISCOURS-SIEGE)

December 31, 2025 updated by: University Hospital, Strasbourg, France

Impact of the Practitioner's Discourse on the Mother's Decision Regarding the Mode of Delivery in Cases of Breech Presentation

Breech presentation is a common occurrence in routine practice, occurring in 3-4% of all term pregnancies. Despite its frequency, breech presentation at term remains a subject of considerable controversy within the medical community. This results in differing management approaches depending on the country, the center, and the practitioner. Indeed, from a pathophysiological perspective, during a breech delivery, the fetal head is the last segment to descend into the maternal pelvis. This is the largest fetal segment in terms of volume. Furthermore, the fetal head cannot accommodate itself to the maternal pelvis through plastic deformation. This presentation can therefore lead to specific complications that may be life-threatening for the unborn child.

Despite its frequency, breech presentation at term remains a subject of considerable controversy within the medical community regarding the management of labor. In the 2000s, a randomized trial called the TERM BREECH TRIAL found a neonatal benefit of planned cesarean section compared to vaginal delivery of a breech fetus (prevention of perinatal death in 1% of cases). This resulted in a significant increase in the rate of planned cesarean sections for breech presentation worldwide. However, numerous more recent studies (notably PREMODA in France) have highlighted the many biases of the Term Breech Trial, and various literature reviews (including the 2015 Cochrane review) have demonstrated lower perinatal morbidity than that found by Hannah's team. In 2020, the CNGOF (National College of Gynecologists and Obstetricians of France) published new recommendations on the management of breech presentations at the end of pregnancy, proposing vaginal delivery as a possible alternative to a planned cesarean section, provided that the patient receives clear and honest information (benefits and risks of each delivery method). The choice of delivery method must be made in consultation with the patient after a dedicated consultation. Since these recommendations were published, management practices still vary between hospitals despite fairly precise guidelines.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • France
      • Strasbourg, France, 67091
        • Recruiting
        • Service de Gynécologique et d'Obstétrique - CHU de Strasbourg - France
        • Contact:
        • Principal Investigator:
          • Mary PONTVIANNE, MD
        • Principal Investigator:
          • Joséphine GRIVEL, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

  • Doctor with a medical degree (Junior Doctor, Clinical Assistant, Hospital Practitioner, University Professor of Obstetrics), with a primary focus on Obstetrics.
  • Patient of legal age (≥ 18 years)
  • Having given birth in 2024 in a university hospital in the Grand-Est region (Besançon, Reims, Strasbourg, Nancy)

Description

Inclusion Criteria:

Regarding practitioners:

  • Doctor with a medical degree (Junior Doctor, Clinical Assistant, Hospital Practitioner, University Professor of Obstetrics), with a primary focus on Obstetrics
  • Practicing in a University Hospital in the Grand Est region (Besançon, Reims, Strasbourg, Nancy)
  • Agreeing to complete the self-administered questionnaire anonymously.

Regarding patients:

  • Patient of legal age (≥ 18 years)
  • Having given birth in 2024 in a university hospital in the Grand-Est region (Besançon, Reims, Strasbourg, Nancy)
  • Delivery of a breech fetus > 37 weeks of gestation
  • Agreeing to answer the self-administered questionnaire anonymously.

Exclusion Criteria:

Regarding practitioners:

Other primary activity than obstetrics

Regarding patients:

  • Minor patient at the time of delivery
  • Patient who had a cesarean section due to a uterine scar and maternal desire.
  • Patients with a history of uterine scarring or the presence of obstruction previa were also excluded due to the impossibility of authorizing vaginal delivery, regardless of fetal presentation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Doctor with a primary focus on Obstetrics
  • Practicing in a University Hospital in the Grand Est region (Besançon, Reims, Strasbourg, Nancy)
  • Agreeing to complete the self-administered questionnaire anonymously.
Other: To complete a questionnaire
Doctor and Adult woman agreeing to complete the self-administered questionnaire anonymously.
Adult woman (≥ 18 years old)
  • Gave birth in 2024 at a university hospital in the Grand Est region (Besançon, Reims, Strasbourg, Nancy)
  • Breech delivery > 37 weeks gestation
  • Agree to complete the self-administered questionnaire anonymously.
Other: To complete a questionnaire
Doctor and Adult woman agreeing to complete the self-administered questionnaire anonymously.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Overall satisfaction of women who gave birth to a breech fetus regarding their medical care
Time Frame: Up to 12 months

Questionnaire from the book "The Joyful and Relaxed Pregnancy Guide"

Score from 0 to 10:

0 = Not at all satisfied 5 = Partially satisfied 10 = Completely satisfied
Up to 12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Strasbourg, France

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 28, 2025

Primary Completion (Estimated)

February 1, 2026

Study Completion (Estimated)

February 1, 2026

Study Registration Dates

First Submitted

December 17, 2025

First Submitted That Met QC Criteria

December 31, 2025

First Posted (Estimated)

January 2, 2026

Study Record Updates

Last Update Posted (Estimated)

January 2, 2026

Last Update Submitted That Met QC Criteria

December 31, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 9537

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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