The Characteristics and Perils of Breech Presentation

Perinatal mortality in breech presentations as compared to vertex presentations in singleton pregnancies: an analysis based upon 57 819 computer-registered pregnancies in The Netherlands

“…The findings of Brenner et al (1974) that, compared to vertex presentations, breech presentations are delivered at lower gestational ages and birthweights and are associated with more frequent congenital malformations which increase with gestational age, are confirmed in this study (Tables I, II, IX). Prior to 33 wk gestation there is probably little significance in the occurrence of a breech rather than a vertex presentation.…”

“…It is even questionable whether routine caesarean section for breech presentation can improve the results. In fact, ' the breech infant is more than just one who happens to be presenting buttocks first' (Brenner, 1974). Finally, computerised registration of obstetric information on a nationwide basis appears to be a useful means to provide a database for the study of obstetric phenomena.…”

Can Labor with Breech Presentation Be Induced?

“…Corrected prenatal mortality rate was 0%, but Apgar scores or neonatal morbidities were not reported. Brenner et al [20] found similar perinatal mortality rates and Apgar scores between patients with breech presentation in whom labor was induced by oxytocin alone, or combined with artificial rupture of membranes, and patients who delivered spontaneously. Rovinsky et al [21] reported that the use of oxytocin for induction of labor in breech presentation is safe.…”

“…Rovinsky et al [21] reported that the use of oxytocin for induction of labor in breech presentation is safe. In both studies [20,21], the number of patients in whom labor was induced, indications for induction and cervical conditions prior to induction, were not reported. Collea et al [22] reported on 4 patients with breech presentation whose labor was induced with Pitocin.…”

Fetal sensory‐elicited body movements differ in breech compared to cephalic position

“…Infants delivered vaginally in the breech compared to cephalic position are at increased risk for adverse perinatal outcome (e.g., Brenner, Bruce, & Hendricks, 1974;Hannah et al, 2000) and score less well on neurological tests of development (e.g., Molkenboer, Roumen, Smits, & Nijhuis, 2006). Presently, it is unclear whether newborn outcome is a consequence of delivery alone, or whether the atypical fetal position leads to in utero neurological impairment (e.g., possibly through alterations in proprioceptive feedback mechanisms) or whether in utero neurological impairment contributes to the breech presentation.…”