Vaginal Breech Delivery

Only 3–4% of babies will adopt a breech presentation at term. Risk factors for breech presentation include fetal abnormality, prematurity, abnormal amniotic fluid volumes and low-lying placenta. Controversy exists among clinicians regarding the mode of delivery for babies in a breech presentation at term with vaginal breech delivery becoming less common following the publication of the Term Breech trial in 2000. Subsequently a number of clinicians have become deskilled in vaginal breech delivery and caesarean section their preferred mode of delivery. This is primarily as a result of the increased perinatal morbidity and mortality associated with vaginal breech delivery compared to a cephalic delivery. Despite the low incidence of breech presentation at term there are a large number of medico legal cases centred around vaginal breech delivery and the undiagnosed breech. These cases have a number of recurring themes; especially late diagnosis and lack of senior obstetric input at the time of delivery.