ACOG committee opinion: number 265, December 2001. Mode of term single breech delivery.

Recently, researchers conducted a large, international multicenter randomized clinical trial comparing a policy of planned cesarean birth with planned vaginal birth. Given the results of this exceptionally large and well-controlled clinical trial, the American College of Obstetricians continue their efforts to reduce breech presentations in singleton gestations through the application of external cephalic versions whenever possible. As a result of the findings of the study, planned vaginal delivery of a term singleton breech may no longer be appropriate. In those instances in which breech vaginal deliveries are pursued, great caution should be exercised. Patients with persistent breech presentation at term in a singleton gestation should undergo a planned cesarean delivery. A planned cesarean delivery does not apply to patients presenting in advanced labor imminent or to patients whose second twin is in a nonvertex presentation.