[Breech presentation, vaginal delivery or cesarean section?]

Since the late sixties, the question of wether a breech presentation should be delivered vaginally or by caesarean section has been discussed by obstetricians, with special reference to the aim of improving foetal outcome. This review of the literature surveys the ante- and intrapartum considerations and activities which should be carried out in cases of breech presentation. The factors influencing foetal and maternal morbidity and mortality are discussed, and external cephalic version is considered. Based on these considerations and a careful examination of the pregnant woman and her obstetric history, we suggest vaginal delivery in strictly selected breech presentations. Selection criteria are given.