Premature breech delivery—the caesarean section debate

Summary

The hazards of vaginal breech delivery occur against a background of delay in delivery, fetal hypoxia and fetal hypotonia. The ordinary manipulations of delivery may then cause damage to the aftercoming head with intra-cranial haemorrhage, well known to be associated with tears of the tentorium and falx, and also skull fractures and occipital diastasis. Significant intracranial damage is found at autopsy much more frequently in infants delivered by the breech than in vertex presentations (Wigglesworth and Husemeyer, 1977). Extracranial injuries involving the spinal cord, abdominal viscera and skeletal muscles can also occur.