ACOG committee opinion. Mode of term singleton breech delivery. Number 265, December 2001. American College of Obstetricians and Gynecologists

Abstract

Recently, researchers conducted a large, international multicenter randomized clinical trial comparing a policy of planned cesarean birth with planned vaginal birth. Given the results of this exceptionally large and well-controlled clinical trial, the American College of Obstetricians and Gynecologists Committee on Obstetric Practice recommends that obstetricians continue their efforts to reduce breech presentations in singleton gestations through the application of external cephalic version whenever possible. As a result of the findings of the study, planned vaginal delivery of a term singleton breech may no longer be appropriate. In those instances in which breech vaginal deliveries are pursued, great caution should be exercised. Patients with persistent breech presentation at term in a singleton gestation should undergo a planned cesarean delivery. A planned cesarean delivery does not apply to patients presenting in advanced labor with a fetus in the breech presentation in whom delivery is likely to be imminent or to patients whose second twin is in a nonvertex presentation.