[Breech presentation--methods of delivery and risks]

Although perinatal mortality is steadily decreasing with the present relatively stable rates of cesarean section, babies born in breech presentation are at a higher risk of perinatal problems and mortality. The higher risk associated with breech delivery is more marked for preterm babies. Vaginal deliveries of term breech babies, however, present only a slightly higher risk than elective cesarean deliveries. Breech presentation is also associated with several inborn diseases or malformations. There is no standard set of general criteria for selecting route of delivery for breech presentations, but when several criteria are combined, they have been shown to reduce the risk when applied in a clinical setting. This article reviews the current knowledge of the management and outcome of breech deliveries, and concludes that vaginal breech deliveries at term are relatively safe if selected on the basis of specific criteria and performed in specialized units.