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Mode of Delivery for Breech Presentation


Here are some studies that discuss management of the breech presentation and the mode of delivery.

  • Jaffa AJ et al: Management of term breech presentation in primigravidae. Br J Obstet Gynaecol 1981;88:721-4.
  • Rosen M and Chik L: The effect of delivery route on outcome in breech presentation. Am J Obstet Gynecol 148:909, 1984. No improvement in neonatal mortality or morbidity shown with increase in cesarean section.
  • Rosen MG, Chik L: The association between cesarean birth and outcome in vertex presentation. Am J Obstet Gynecol 1984;150:775.
  • Green JE et al. Has an increased cesarean section rate for term breech delivery reduced the incidence of birth asphyxia, trauma and death? Am J Obstet Gynecol 1982;142:643.
  • Oian P et al: Breech delivery: an obstetrical analysis. Acta Obstet Gynecol Scand 67:75-79, 1988. (Large rise in breech c-sec rate in Norway in late 70s at this hospital, "Neonatal mortality figures were not significantly improved for infants delivered by cesarean section.")
  • Weiner CP: Vaginal breech delivery in the 1990s. Clinical Obstet and Gynecol 35:3,559-69, 1992. ["Since then (1959), others have observed that the dramatic increase in the rate of cesarean delivery for the breech presentation has not been associated with a parallel improvement in outcome above that observed for the vertex fetus during the same time."] ["Third, when good clinical sense was applied, the selected near-term and term breech fetus was delivered as safely through the vagina as through the abdomen. Fourth, cesarean section did not eliminate the risk of a traumatic delivery. The latter is contrary to the beliefs of many medical, legal, and lay individuals."]
  • Woo JSK et al: Term breech delivery - is a high cesarean section rate justified? ["No significant difference in perinatal outcome was noted in the group delivered vaginally in two years."] Aust. NZ J Obstet Gynaec 23:25-27, 1983.
  • Bird, CC and McElin, TW: A 6-year prospective study of term breech deliveries utilizing the Zatuchni-Andros Prognostic Scoring Index. Am J Obstet Gynecol 121:551,1975.
  • Collea JV et al: The randomized management of term frank breech presentation: Vaginal delivery vs. cesarean section, Am J Obstet Gynecol 131:186,1978.
  • Collea JV: Current management of breech presentation, Clin Obstet Gynecol. 23:525, 1980. ("It should be understood, however, that infants with breech presentation who are deliverd incorrectly may be injured at cesarean section. Every obstetrician should be thoroughly familiar with the manual art of breech extraction before attempting to perform an abdominal breech delivery, for the manual techniques of breech delivery from the uterus at cesarean section involve the same dexterity that is essential for a safe vaginal delivery.")
  • Collea JV et al. The randomized management of term frnk breech presentation: a study of 208 cases. Am J Obstet Gynecol 1980;137:235-44. (Bruce Rolf, MD, writes: "Not all infants are easily delivered by cesarean section, especially those with breech presentation. Many times we have seen unnecessary delays and perhaps traumatized infants when an inadequate transverse lower-segment incision was used.")
  • Gimovsky ML et al: Neonatal performance of the selected term vaginal breech delivery, Obstet Gynecol 56:687, 1980.
  • Gimovsky ML et al: Randomized management of the nonfrank breech presentation at term: a preliminary report. Am J Obstet Gynecol 1983;146-34-40.
  • Myers SA and Gleicher N: Breech delivery: Why the dilemma? Am J Obstet Gynecol 1987;156-6-10
  • Bilodeau R and Marier R: Breech presentation at term, Am J Obstet Gynecol 130:555, 1978.
  • Rovinsky JJ et al: Management of breech presentation at term, Am J Obstet Gynecol 115:497, 1973. ("routine elective cesarean section for term breech presentation is not justified.")
  • Mann LI and Gallant JM: Modern management of the breech delivery, Am J Obstet Gynecol 134:611, 1979. (457 breech deliveries - no "significant improvement in neonatal mortality and morbidity rates for those delivered by cesarean section vs. vaginal delivery").
  • Croughan-Minihane MS et al: Morbidity among breech infants according to method of delivery, Obstet Gynecol 75:821, 1990. (1240 singleton breeches
  • Graves W: Breech delivery in 20 years of practice, Am J Obstet Gynecol 137:229,1980. - JP Shively, MD, writes: "It was once said that to judge an obstetrician, one should observe his management of a breech presentation. Perhaps this adage is becoming passe, so I wonder how the next generation of obstetricians will perform when they have an emergency situation requiring delivery. I understand that many residents in training are not being taught how to deliver breech babies." JO McCall, MD, writes: "I submit to you that you will see some very awkward and difficult breech deliveries at the time of cesarean section. I encourage all of you who are preceptors with resident training programs to urge every resident to read Potter's classic description of how to handle a breech."
  • Green J et al. Has an increased cesarean section rate for term breech delivery reduced the incidence of birth asphyxia, trauma, and death? Am J Obstet Gynecol 142:643, 1982. 770 term breech deliveries, Ontario. "The results of this study show that an increase in the rate of cesarean section for term breech deliveries from 22% to 94% has not reduced unfavorable outcome significantly, although a trend toward decreased trauma and death may exist."



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