Dilemma in Breech Delivery: A Review

The incidence of breech presentation seems to have remained steady at about 3- 5 % of singleton pregnancies after 37 weeks of pregnancy. However the rate of caesarean section for breech has risen significantly. Decreasing rate of vaginal breech delivery may mean increased morbidity and mortality for the mother and baby. It may also mean that the expertise of conducting a breech delivery may be dwindling.

Contrasting the findings of The Term Breech Trial which advocated caesarean section for breech births, the newer studies like the PREMODA study, FRABAT study, RCOG, FIGO and others have not shown any increase in risk to the baby or mother after vaginal breech delivery. They have suggested that planned vaginal Breech Birth can be a safe option for the patient to choose, in properly selected patients. Patient education and stressing the importance of regular antenatal clinic check-ups will help take the correct and informed decision of either a planned vaginal delivery or elective caesarean section.

The art of external cephalic version and the art of conducting vaginal breech delivery needs to be relearnt and percolated to the junior staff.