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Related Experiment Videos

Management of term breech presentation.

T A Flanagan, K M Mulchahey, C C Korenbrot

    American Journal of Obstetrics and Gynecology
    |June 1, 1987
    PubMed
    Summary
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    External cephalic version (ECV) can successfully convert breech presentations to cephalic before labor. Selected breech cases managed with a trial of labor achieve high vaginal birth rates without increased risk.

    Area of Science:

    • Obstetrics and Gynecology
    • Maternal-Fetal Medicine

    Background:

    • Singleton breech presentation at term requires careful management.
    • External cephalic version (ECV) is an intervention to convert breech to cephalic presentation before labor.

    Purpose of the Study:

    • To review the management of term singleton breech presentations.
    • To evaluate the success rates and outcomes of external cephalic version and trial of labor in selected breech cases.

    Main Methods:

    • Retrospective review of 716 singleton breech presentations at ≥37 weeks gestational age.
    • Analysis of external cephalic version attempts, trial of labor outcomes, and cesarean delivery rates.
    • Stratification of cases based on labor status and delivery mode.

    Main Results:

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    • External cephalic version was offered to 433 (61%) cases identified before labor, with a 48% success rate (83/171 attempts).
    • Among 623 remaining breech presentations, 175 underwent a trial of labor resulting in vaginal delivery (72% success rate).
    • Trial of labor in selected patients did not increase maternal or fetal mortality/morbidity.

    Conclusions:

    • External cephalic version followed by a trial of labor in selected breech presentations is a safe and effective strategy.
    • This management approach can achieve a high rate of vaginal delivery without compromising maternal or fetal outcomes.
    • The combined strategy of ECV and selective trial of labor is cost-effective.