Management of Breech Presentation

This is the authors' abstract. We don't add key points for this paper.

Women should be informed that a higher risk planned vaginal breech birth is expected where there are independent indications for caesarean section and in the following circumstances: C Hyperextended neck on ultrasound.High estimated fetal weight (more than 3.8 kg).Low estimated weight (less than tenth centile).Footling presentation.Evidence of antenatal fetal compromise.[New 2017] The role of pelvimetry is unclear.[New 2017]C Skill and experience of birth attendantThe presence of a skilled birth attendant is essential for safe vaginal breech birth. CUnits with limited access to experienced personnel should inform women that vaginal breech birth is likely to be associated with greater risk and offer antenatal referral to a unit where skill levels and experience are greater.[New 2017] Intrapartum assessment and management of women presenting unplanned with breech presentation in labour Where a woman presents with an unplanned vaginal breech labour, management should depend on the stage of labour, whether factors associated with increased complications are found, availability of appropriate clinical expertise and informed consent.[New 2017]C Women near or in active second stage of labour should not be routinely offered caesarean section.[New 2017]Where time and circumstances permit, the position of the fetal neck and legs, and the fetal weight should be estimated using ultrasound, and the woman counselled as with planned vaginal breech birth.[New 2017] All maternity units must be able to provide skilled supervision for vaginal breech birth where a woman is admitted in advanced labour and protocols for this eventuality should be developed. [New 2017]What is appropriate intrapartum management of the term breech?Are induction and augmentation appropriate?Women should be informed that induction of labour is not usually recommended.Augmentation of slow progress with oxytocin should only be considered if the contraction frequency is low in the presence of epidural analgesia.[New 2017]