Vaginal breech delivery: is it still an option?

Objective: To provide local data on term breech delivery for future guidance. Study design: Retrospective, 'intended-mode-of-delivery' analysis of 711 antenatally uncomplicated singleton breech deliveries at greater than or equal to37 weeks: 445 (63%) planned for vaginal delivery (VD) (no fetal growth restriction, fetal weight 2000-4000 g, adequate pelvic size, maternal consent) and 266 for cesarean section (CS). Outcome measures: Apgar score, cord blood acid-base status, childhood deaths and disability. Results: Perinatal mortality was nil in both groups. Low 1-min Apgar scores and low arterial cord blood pH were significantly more frequent in planned VD, but not low Apgar scores at 5 or 10 min or low venous pH. Metabolic acidosis, neonatal intensive care, neonatal seizures, birth trauma, childhood death (CS = 1), and neurodevelopmental handicaps (CS = 2, VD = 1) were equally common. Conclusion: Our results do not disqualify selective vaginal breech delivery at term and beyond as an option. (C) 2003 Elsevier Ireland Ltd. All rights reserved.