Breech deliveries and C/S

Four to five percent of singleton pregnancies at term are complicated by breech presentation. Complications occur in about 60% of breech deliveries. Fetuses presented by the breech are at increased risk of birth injuries and hypoxia during vaginal delivery. The management of breech presentation is in a state of flux at the present time. Use of cesarean section is increasing. External version-even with the Lise of tocolytic agents for relaxation- is dangerous because its possible complications. in our practice vaginal delivery is preferred if the following crileria are completed: frank breech only, estimatecl fetal weight of 2500-350()g, adequate pelvimetry without hyperextended head, normal progression of labor, no evidence of fetal hypoxia with continous fetal monitoring, and the weight of the mother is under 90 kg. Vaginal frank breech delivery at term may be just as safe as cesarean section when careful selection crileria are used. If these criteria are not fulfilled, or the fetal monitoring cannot be performed, cesarean section is advisable. The increasing rate of cesarean section significantly lowered the perinatal morbidity and morlality in developed countries in the past decades. in developing countries the operative background tor cesarean section is not widely available. İn these countries the attending personel need to be trained to perform breech deliveries to safely deliver these fetuses.