[Breech presentation, vaginal delivery or cesarean section?]

Area of Science:

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

Background:

• The optimal delivery method for breech presentation (fetal buttocks or feet first) has been debated since the 1960s, focusing on improving fetal survival and reducing complications.
• Decisions regarding vaginal birth versus cesarean section for breech presentation significantly impact both maternal and infant health outcomes.

Purpose of the Study:

• To review current literature on the management of breech presentations.
• To identify key antepartum and intrapartum considerations for optimizing fetal and maternal outcomes.
• To evaluate the role of external cephalic version and establish criteria for selecting suitable cases for vaginal breech delivery.

Main Methods:

• Comprehensive literature review of studies on breech presentation management.
• Analysis of factors affecting fetal and maternal morbidity and mortality.
• Discussion of external cephalic version techniques and success rates.
• Development of strict selection criteria for attempting vaginal breech delivery.

Main Results:

• Identification of critical factors influencing the safety of vaginal breech delivery.
• Evidence supporting the efficacy and safety of external cephalic version in converting breech to cephalic presentation.
• Defined criteria for patient selection, enabling successful vaginal breech deliveries in appropriate cases.

Conclusions:

• Vaginal delivery is a viable and safe option for carefully selected breech presentations.
• A thorough assessment of maternal and fetal factors is crucial for determining the mode of delivery.
• External cephalic version should be considered as an intervention to increase the likelihood of vaginal birth.