SOGC clinical practice guideline: Vaginal delivery of breech presentation: no. 226, June 2009.
OBJECTIVE
To review the physiology of breech birth; to discern the risks and benefits of a trial of labour versus planned Caesarean section; and to recommend to obstetricians, family physicians, midwives, obstetrical nurses, anaesthesiologists, pediatricians, and other health care providers selection criteria, intrapartum management parameters, and delivery techniques for a trial of vaginal breech birth.


METHODS
Trial of labour in an appropriate setting or delivery by pre-emptive Caesarean section for women with a singleton breech fetus at term.


RESULTS
Reduced perinatal mortality, short-term neonatal morbidity, longterm infant morbidity, and short- and long-term maternal morbidity and mortality.


METHODS
Medline was searched for randomized trials, prospective cohort studies, and selected retrospective cohort studies comparing planned Caesarean section with a planned trial of labour; selected epidemiological studies comparing delivery by Caesarean section with vaginal breech delivery; and studies comparing long-term outcomes in breech infants born vaginally or by Caesarean section. Additional articles were identified through bibliography tracing up to June 1, 2008.


METHODS
The evidence collected was reviewed by the Maternal Fetal Medicine Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC) and quantified using the criteria and classifications of the Canadian Task Force on Preventive Health Care.


RESULTS
This guideline was compared with the 2006 American College of Obstetrician's Committee Opinion on the mode of term singleton breech delivery and with the 2006 Royal College of Obstetrician and Gynaecologists Green Top Guideline: The Management of Breech Presentation. The document was reviewed by Canadian and International clinicians with particular expertise in breech vaginal delivery.
Kotaska
Andrew
A
Menticoglou
Savas
S
Gagnon
Robert
R
Farine
Dan
D
Basso
Melanie
M
Bos
Hayley
H
Delisle
Marie-France
MF
Grabowska
Kirsten
K
Hudon
Lynda
L
Mundle
William
W
Murphy-Kaulbeck
Lynn
L
Ouellet
Annie
A
Pressey
Tracy
T
Roggensack
Anne
A
D001946:Breech Presentation; D002170:Canada; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008428:Maternal Mortality; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D014219:Trial of Labor