Prognostic index for vaginal delivery in breech presentation at term: Prospective study

Abstract

The obstetric decision of allowing the vaginal delivery of a term fetus in breech presentation is fraught with danger. In our present state of knowledge, the choice of abdominal versus vaginal delivery in these cases resides mostly in the obstetrician's experience. It is unfortunate that this decision is the wrong one on far too many occasions. Retrospective analysis of term breech presentation has led us to the development of a Breech Scoring Index. The present study, a prospective one, emphasizes the usefulness of the Index in selecting those patients whose labor should be terminated by the abdominal route. Experience with the Breech Index demonstrates that approximately 20 per cent of patients with a term fetus in breech presentation will require cesarean section. The morbidity and mortality associated with breech presentation will be significantly decreased by the use of the Breech Index.