No. 384-Management of Breech Presentation at Term.

OBJECTIVES: 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.

OPTIONS: Planned vaginal breech birth or planned Caesarean section for women with a singleton breech fetus at term.

OUTCOMES: Perinatal mortality, short- and long-term neonatal/infant morbidity, maternal mortality, and short- and long-term maternal morbidity.

EVIDENCE: 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.

VALIDATION: 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.

SPONSORS: The Society of Obstetricians and Gynaecologists of Canada.

SUMMARY STATEMENTS: RECOMMENDATIONS: Labour Selection Criteria Labour Management Delivery Technique Setting and Consent.