Breech presentation and mode of delivery

What it is

The incidence of breech presentation is about 20% at 28 weeks; the incidence at term is 3-4%. There is higher perinatal mortality and morbidity with breech presentation, due to prematurity, congenital malformation, and perinatal asphyxia or trauma — and the protocol states it in one line: breech presentation, whatever the mode of delivery, is a signal for potential fetal handicap.

For term breech, meaning 37 weeks to 42 weeks, in multiparous women, a Canadian funded international multicentre RCT recommended that the best method of delivering a term frank or complete breech is by planned L.S.C.S., as it showed that P.N.M was reduced by 75%.

The abbreviations the document defines for itself: L.S.C.S is lower segment caesarean section; C.S is cesarean section; ELSCS is emergency lower segment caesarean section; IUGR is intra uterine growth restriction; E.F.W is estimated fetal weight; E.C.V is external cephalic version; PNM is perinatal mortality; TOL is trial of labour.