Undiagnosed breeches presenting in labour—should they be allowed a trial of labour?

Summary

Summary

We studied 24 women who had an undiagnosed breech presentation in labour and compared them to a control population of 48 women where the breech was diagnosed and assessed antenatally, to determine if there were any factors important in deciding the mode of delivery of an undiagnosed breech presentation, and to compare outcomes for mother and baby. Women in the study group achieved a 60 per cent vaginal delivery rate where clinical assessment allowed a trial of labour. The maternal morbidity for all women achieving a vaginal delivery was lower than that for caesarean section hut was lowest where the breech was also diagnosed antenatally. Clinical assessment of fetal size was accurate in identifying all fetuses weighing > 3.8 kg. No significant difference in the fetal outcome was found if the breech was diagnosed or undiagnosed, or in relation to the eventual mode of delivery. The practice of individual assesment for optimum mode of delivery of women with undiagnosed breech presentations in labour should continue with vaginal delivery as an acceptable option.