Patterns of management with breech presentation

A review of 12 years' experience with term breech delivery at Overlake Memorial Hospital, Bellevue, Washington, was undertaken to ascertain patterns of care as practiced in a suburban community hospital setting. A total of 402 term breech deliveries were managed by 34 family practitioners and 21 obstetricians. X-ray pelvimetry was found to correlate with clinical pelvimetry in two thirds of the cases when used. There were 314 patients delivered vaginally and 88 by cesarean section (an over-all cesarean section rate of 21.9%). There was a striking increase to 43.9% during the last 2 years of the review. This review indicates increasing utilization of consultation with breech presentation, an increasing percentage managed by obstetricians, increasing use of x-ray pelvimetry, decreasing frequency of prolonged labor, a sharp increase in use of cesarean section, and a decline in perinatal morbidity.