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Breech delivery
Sambit Mukhopadhyay1, Sabaratnam Arulkumaran
1Department of Obstetrics & Gynaecology, Derby City General Hospital, Derby, UK.
Fetuses that present by the breech are at increased risk of trauma and hypoxia during delivery. The threshold for Caesarean section for breech presentation had been low for several years. The result of the term breech trial confirms that planned Caesarean section is the best method of delivering the singleton frank or complete breech at term. The best mode of delivery for the pre-term breech is less clear. Vaginal breech delivery will be unavoidable in certain circumstances and it is therefore important to be adept with the techniques of vaginal breech delivery. The atraumatic technique of delivery of the baby presenting by the breech at times of Caesarean section is similar to that of assisted vaginal breech delivery. The number of vaginal breech deliveries is falling, and regular teaching using video clips or practising with mannequins will be necessary to preserve the skills of vaginal breech delivery.
Fetuses that present by the breech are at increased risk of trauma and hypoxia during delivery. The threshold for Caesarean section for breech presentation had been low for several years. The result of the term breech trial confirms that planned Caesarean section is the best method of delivering the singleton frank or complete breech at term. The best mode of delivery for the pre-term breech is less clear. Vaginal breech delivery will be unavoidable in certain circumstances and it is therefore important to be adept with the techniques of vaginal breech delivery. The atraumatic technique of delivery of the baby presenting by the breech at times of Caesarean section is similar to that of assisted vaginal breech delivery. The number of vaginal breech deliveries is falling, and regular teaching using video clips or practising with mannequins will be necessary to preserve the skills of vaginal breech delivery.
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