Undiagnosed breech in Zaria, Nigeria

There is no certainty about the best way of dealing with a breech presentation first diagnosed in labour. In our unit, the decision to allow a trial of vaginal delivery rested on the clinical assessment of the size of the baby and the maternal pelvis, and the progress of labour. We compared the outcome of 32 cases where a breech presentation was first diagnosed in labour with 65 women where the malpresentation was diagnosed antenatally where a full assessment including ultrasound and radiological pelvimetry could be made. There was no significant difference in the mode of delivery and fetal outcome. We continue to favour careful case selection for vaginal delivery even where the breech is first diagnosed in labour.