The obstetric management of the premature breech

It has long been recognized that the preterm infant presenting by the breech runs an increased risk compared to other presentations at vaginal delivery. Several authors have reported on a tendency of the aftercoming head to be entrapped in the incompletely dilated cervix, a greater likelihood of cord accidents and an increased risk for asphyxia. Concern about the high mortality rate associated with vaginal preterm breech delivery has caused many obstetricians to question whether the fetal outcome could be improved by alternative obstetric management and especially if caesarean section should be advocated or not.