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[Breech presentation, vaginal delivery or cesarean section?]

K Vangsgaard, A Grønlund

    Ugeskrift for Laeger
    |November 18, 1996
    PubMed
    Summary
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    Vaginal delivery is suggested for carefully selected breech presentations to improve fetal outcomes. This review details antepartum and intrapartum considerations, influencing factors, and external cephalic version.

    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.

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  • 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.