50. Breech Delivery

  1. John T. Queenan MD3,
  2. Catherine Y. Spong MD4 and
  3. Charles J. Lockwood MD5
  1. Edward R. Yeomans MD1 and
  2. Larry C. Gilstrap III MD2

Published Online: 4 JAN 2012

DOI: 10.1002/9781119963783.ch50

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition

How to Cite

Yeomans, E. R. and Gilstrap, L. C. (2012) Breech Delivery, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch50

Editor Information

  1. 3

    Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA

  2. 4

    Bethesda, MD, USA

  3. 5

    Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

Author Information

  1. 1

    Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Lubbock, TX, USA

  2. 2

    American Board of Obstetrics and Gynecology, Dallas, TX, USA

Publication History

  1. Published Online: 4 JAN 2012
  2. Published Print: 24 FEB 2012

ISBN Information

Print ISBN: 9780470655764

Online ISBN: 9781119963783

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Keywords:

  • breech delivery;
  • maternal/perinatal outcomes, vaginal breech delivery;
  • selection criteria, attempted vaginal breech delivery;
  • neonatal morbidity and breech delivery;
  • labor management;
  • vaginal breech delivery technique;
  • Mauriceau–Smellie–Veit maneuver;
  • Piper or Laufe–Piper forceps;
  • CD for term breech presentation

Summary

In the US, the rate of cesarean delivery for infants in breech presentation has been equal to or greater than 80% for the last 30 years. The results of the Term Breech Trial published in 2000 supported a policy of planned cesarean delivery for breech presentation and a Committee Opinion from the American College of Obstetricians and Gynecologists initially upheld the conclusions of the Term Breech Trial. However, we presented evidence in the previous edition of this textbook that supported an attempt at vaginal breech delivery in carefully selected and consenting women. Shortly afterwards, the American College of Obstetricians and Gynecologists issued a revised Committee Opinion (#340), recommending that the decision regarding mode of delivery should depend on the experience of the healthcare provider. In June 2009, the Society of Obstetricians and Gynaecologists of Canada published a practice guideline on vaginal delivery of breech presentation. That document incorporates many of the principles that we advocated in our previous work. The objectives of this revised chapter are to: 1) present up-to-date guidance on selection criteria for attempted vaginal breech delivery, 2) review the management of labor in women with breech presentation at term, and 3) highlight important technical aspects of vaginal breech delivery. Many of these techniques are equally applicable to cesarean delivery of the breech fetus since even for obstetric units with considerable expertise in vaginal breech delivery, it is highly likely that more than half of breech deliveries will be conducted via cesarean section.