Breech deliveries and cesarean section
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Z. Papp
Abstract
Breech presentation is the most common malpresentation, with about 3–4% of singleton fetuses presenting breech at delivery. Management of breech presentation has been a contentious issue with a lowering threshold for cesarean section in recent years.
Perinatal mortality and morbidity are estimated to be three times that of comparable infants with vertex presentation. Breech presentation is commonly associated with certain adverse maternal and fetal factors which inherently give rise to increased perinatal morbidity and mortality.
At present, most obstetricians favor cesarean delivery for uncomplicated pre-term breech. Controlled prospective studies have shown that the outcome of breech fetuses weighing more than 1500 g was not dependent on the mode of delivery. A more recent review from the Cochrane database by Grant does not justify a policy of elective cesarean section for pre-term breech.
Vaginal delivery is preferred if the following criteria are met: frank breech only, estimated fetal weight of 2500–3500 g, adequate pelvimetry without hyperextended head, normal progression of labor, no evidence of fetal hypoxia under continuous fetal monitoring, and maternal weight under 90 kg. Vaginal delivery of frank breech at term may be just as safe as cesarean section when careful selection criteria are used. If these criteria are not fulfilled, or fetal monitoring cannot be performed, cesarean section is advisable.
Copyright © 2003 by Walter de Gruyter GmbH & Co. KG
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Artikel in diesem Heft
- Message from the President of the WCPM
- Message from the President of the WAPM
- Antalya Consensus on Perinatal Care:The Report of the 2nd World Congress of Perinatal Medicine for Developing Countries, 1–5 October 2002, Antalya, Turkey
- Reduction in mortality needs a bit more than the science of perinatology
- Global, regional and national perinatal and neonatal mortality
- Maternal mortality in Turkey
- Maternal mortality in developing countries
- Organization of neonatal care services and its importance
- The Misgav Ladach method – a step forward in operative technique in obstetrics
- Monitoring the IUGR fetus
- Massive obstetric hemorrhage
- Breech deliveries and cesarean section
- Iron supplementation in pregnancy
- Antenatal diagnosis and prognosis of conjoined twins – a case report
- Preliminary report on a new and noninvasive method for the assessment of fetal lung maturity
- Perinatal mortality rate – hospital based study during 1998–2001 at Hacettepe University
- The effect of glucocorticoid therapy on prevention of early neonatal complications in preterm delivery
- Congress Calendar
