No. 384-Management of Breech Presentation at Term.

To discern the risks and benefits of planned vaginal breech birth versus planned Caesarean section and to recommend selection criteria, intrapartum management parameters, and delivery techniques for vaginal breech birth. Planned vaginal breech birth or planned Caesarean section for women with a singleton breech fetus at term. Perinatal mortality, short- and long-term neonatal/infant morbidity, maternal mortality, and short- and long-term maternal morbidity. Medline was searched up to April, 2018 for randomized trials and cohort studies comparing outcomes after planned vaginal breech birth and planned Caesarean section and for cohort studies comparing vaginal breech birth techniques. Additional articles were identified through bibliography tracing. This guideline was peer reviewed by international clinicians with expertise in vaginal breech birth and compared with the 2017 Royal College of Obstetricians and Gynaecologists Green Top Guideline 20b: Management of Breech Presentation. The content and recommendations were drafted and agreed upon by the principal authors. The Board of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology framework. The Society of Obstetricians and Gynaecologists of Canada. RECOMMENDATIONS: Labour Selection Criteria Labour Management Delivery Technique Setting and Consent.

Kotaska A ，Menticoglou S 《-》

Vaginal delivery of breech presentation.

Kotaska A ，Menticoglou S ，Gagnon R ，MATERNAL FETAL MEDICINE COMMITTEE ... -  《-》

SOGC clinical practice guideline: Vaginal delivery of breech presentation: no. 226, June 2009.

Kotaska A ，Menticoglou S ，Gagnon R ，Farine D ，Basso M ，Bos H ，Delisle MF ，Grabowska K ，Hudon L ，Mundle W ，Murphy-Kaulbeck L ，Ouellet A ，Pressey T ，Roggensack A ，Society of Obstetricians and Gynaecologists of Canada ... -  《-》

Reconsideration of planned vaginal breech delivery in selected cases.

Achanna S ，Nanda J ，Paramjothi P 《-》

The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies.

The mode of delivery in term singleton breech presentation has been debated for more than half a century and has been examined in both randomised and observational studies. To determine the absolute and relative risks of perinatal mortality and morbidity in planned vaginal breech delivery. A computer-based literature search was conducted mainly in the databases of HINARI, PubMed and Google scholar for studies comparing planned vaginal delivery and planned caesarean section. Studies that assessed the perinatal mortality and morbidity in relation to the term singleton breech mode of delivery between 1993 and 2014 were included. In this meta-analysis, 27 articles with a total sample size of 258 953 women were included. Relative and absolute risks of perinatal mortality and morbidity in relation to mode of delivery were determined. The relative risk of perinatal mortality and morbidity was about two- to five-fold higher in the planned vaginal than in the planned caesarean delivery group. The absolute risks of perinatal mortality, fetal neurologic morbidity, birth trauma, 5-minute Apgar score <7 and neonatal asphyxia in the planned vaginal delivery group were 0.3, 0.7, 0.7, 2.4 and 3.3%, respectively. Perinatal mortality and morbidity in the planned vaginal breech delivery were significantly higher than with planned caesarean delivery. Even taking into account the relatively low absolute risks of vaginal breech delivery, the current study substantiates the practice of individualised decision-making on the route of delivery in a term breech presentation. Although vaginal breech delivery is controversial, this review has shown low absolute risk.

Berhan Y ，Haileamlak A 《-》