Management of term breech presentation in primigravidae

In a prospective study of 231 breech presentations in primigravidae at term 260 (81 per cent) were delivered vaginally with no perinatal mortality. A single case of fetal injury (Erb's palsy) was recorded and only one infant had an Apgar score of under 7 at 5 minutes. In 17 patients selected for vaginal delivery, caesarean section was necessary for abnormal uterine activity, prolapse of the umbilical cord of fetal distress. Elective caesarean section wad performed if routine x-ray pelvimetry showed values below defined limits at the brim, midcavity, or outlet or if the fetal head was extended.