title: Management of breech presentation at term: a retrospective cohort study of 10 years of experience.
abstract: OBJECTIVE
  To evaluate the impact of management of childbirth (external cephalic version (ECV) plus planned vaginal delivery (PVD)) of breech presentation at term (⩾37 weeks of gestation).
  
  
  METHODS
  This retrospective cohort study was based on data collected of singleton breech presentations at term in the Obstetrics and Gynaecology Service, Cruces University Hospital (Biscay, Spain), from January 2003 to December 2012.
  
  
  RESULTS
  We attended 2377 singleton breech pregnancies at term. We attended 1684 singleton breech term deliveries, attempting vaginal delivery after selection in 52.9% of cases and were successful in 57.5% of attempts. A total of 1360 ECV were attempted, with a success rate of 50.3% of those attempted. The use of ECV has decreased the rate of breech presentation at delivery by 39.0%, the rate of breech presentation as a caesarean section (CS) indication by 47.1% (CS due to breech presentation/total of CS) and the rate of CS for breech presentation out of the total of deliveries by 39.1% (CS due to breech presentation/total of deliveries). Early postnatal parameters (5-min Apgar score, umbilical cord arterial pH and acid-base analysis) were significantly lower following PVD compared with planned CS for breech presentation. However, we did not find any differences in the rates of admissions to the neonatal unit or neonatal mortality.
  
  
  CONCLUSIONS
  Management of breech presentation with a protocol that includes ECV, careful selection criteria and active management of vaginal delivery achieve a great decrease in the rate of CS for breech presentation.
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-9923-9403
authors.initials: J
authors.lastname: Burgos
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Rodríguez
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Cobos
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Osuna
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Del Mar Centeno
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Larrieta
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Martínez-Astorquiza
authors.affiliation: Obstetrics and Gynaecology Service, BioCruces Health Research Institute, Hospital Universitario Cruces (UPV/EHU), Biscay, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Fernández-Llebrez
mesh_terms: D000328:Adult; D001946:Breech Presentation / Q000628:therapy*; D002585:Cesarean Section / Q000706:statistics & numerical data*; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013030:Spain; D047929:Term Birth; D014710:Version, Fetal / Q000379:methods* / Q000706:statistics & numerical data*