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[Breech Presentation: CNGOF Guidelines for Clinical Practice - Short Text].

L Sentilhes1, T Schmitz2, E Azria3

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Gynecologie, Obstetrique, Fertilite & Senologie
|November 4, 2019
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Summary
This summary is machine-generated.

Planned vaginal delivery for breech presentation at term is a reasonable option, with low risks for mother and child. External cephalic version (ECV) can reduce cesarean rates. Shared decision-making is key.

Keywords:
Breech presentationCésarienne programméeExternal cephalic versionMaternal and neonatal morbidityMorbidité maternelle et néonatalePlanned cesarean deliveryPlanned vaginal deliverySiègeTentative de voie basseVersion par manœuvre externe

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine

Background:

  • Singleton breech presentation occurs in 5% of deliveries.
  • Planned vaginal delivery is chosen by one-third of these women, with a 70% success rate.

Purpose of the Study:

  • To determine the optimal management of singleton breech presentation at term.
  • To evaluate risks and benefits of different delivery modes.

Main Methods:

  • Consultation of PubMed, Cochrane Library, and obstetrical society recommendations.
  • Review of evidence levels (LE) and professional consensus.

Main Results:

  • External cephalic version (ECV) reduces breech presentation at birth and cesarean rates without increasing maternal or perinatal morbidity.
  • Planned vaginal delivery may have a slightly increased risk of perinatal mortality or neonatal morbidity compared to planned cesarean delivery.
  • No significant differences in neurodevelopmental or long-term cognitive outcomes between planned vaginal and cesarean delivery.
  • Maternal complications are similar, but previous cesarean delivery increases risks in subsequent pregnancies.

Conclusions:

  • Planned vaginal delivery is a reasonable option for most term breech presentations.
  • Risks of severe morbidity for mother and child are low with both planned vaginal and cesarean delivery.
  • Informed shared decision-making between woman and caregiver is crucial for choosing the delivery route.