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Related Experiment Videos

Management of breech presentation at term

H C Han1, K H Tan, S Y Chew

  • 1Department of Gynaecological Oncology and Urology, Kandang Kerbau Hospital, Singapore.

Singapore Medical Journal
|June 1, 1993
PubMed
Summary

Trial of labor for breech presentation in carefully selected women can lead to successful vaginal delivery in 70.8% of cases. This approach did not increase risks for mothers or babies.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Maternal-Fetal Medicine

Background:

  • Singleton breech presentation is a common obstetric complication.
  • Management options include planned cesarean delivery or a trial of labor.
  • Evidence-based guidelines for trial of labor in breech presentation are crucial.

Purpose of the Study:

  • To review the outcomes of singleton breech presentations managed at term.
  • To evaluate the safety and efficacy of a trial of labor in carefully selected patients.
  • To determine the success rate of vaginal breech delivery.

Main Methods:

  • Retrospective review of 159 consecutive women with singleton breech presentation at ≥37 weeks gestation.
  • Stratification into three management groups: immediate cesarean, trial of labor with cesarean, and trial of labor with vaginal delivery.
  • Analysis of maternal and fetal variables influencing trial of labor outcomes.

Main Results:

  • A trial of labor in carefully selected patients resulted in vaginal delivery in 70.8% of cases (51 out of 72).
  • Immediate cesarean section was performed in 87 women.
  • Trial of labor leading to cesarean section occurred in 21 women.
  • No significant increase in maternal or fetal mortality or morbidity was observed.

Conclusions:

  • A carefully selected trial of labor for singleton breech presentation at term is associated with a high success rate for vaginal delivery.
  • This management strategy can be safely implemented without compromising maternal or fetal outcomes.
  • Clear criteria for patient selection are essential for successful vaginal breech delivery.

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