Highlights in Obstetrics From the 50th Annual Meeting of The American College of Obstetricians and Gynecologists

David Cole, MD


June 11, 2002

In This Article


The Hannah study randomized patients with fetuses in breech presentation between planned vaginal breech delivery and planned cesarean section. The study was done in 121 centers in 26 countries. It demonstrated that planned cesarean delivery is safer for the fetus than planned vaginal birth.[14] Over 85% of breeches in the United States were delivered by cesarean before the study was undertaken. In December 2001, ACOG Committee Opinion 265 dealt with the issue of breech delivery and recommended that cesarean delivery be the standard of care for full-term breeches.[15] The Committee Opinion did not recommend cesarean for the second twin, if breech, or for breeches that present in advanced labor. However, if residents in obstetrics are not given enough experience to do vaginal breech delivery, then these physicians may not be comfortable doing a vertex/breech twin vaginal delivery. Obstetricians need to be aggressive in doing external cephalic versions to potentially help a patient avoid a cesarean for a breech.


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