Singleton breech presentation in labor: experience in 1980

Abstract

Excessive perinatal loss is associated with breech presentation, and, in large measure, this loss is accounted for by prematurity, congenital anomalies, and birth trauma. In the endeavor to exert an effect on two of these problems, cesarean section has been resorted to increasingly. Three hundred thirty singleton breech pregnancies were reviewed, and delivery in 74.2% of these was by cesarean section. The only cases in which a trial of labor was routinely allowed were frank breech presentations at term. Fetal compromise during labor and delivery was relatively uncommon and seen to occur at both vaginal delivery and cesarean section. Preventable mortality was limited to infants who weighed less than 1,300 gm. Morbidity was also primarily associated with low birth weight, and was not significantly different in term infants delivered vaginally and those delivered by cesarean section. The conclusion drawn is that a liberal policy toward the use of cesarean section for breech presentation is necessary in conjunction with the manual skills required to effect a safe breech delivery, in order to minimize perinatal loss.