Breech delivery.

Perinatal mortality in 700 cases of breech delivery was studied retrospectively and results were compared with those of controls. Cases were matched with those of cephalic presentation for maternal age and parity, foetal gestational age, and birthweight. The perinatal mortality was more than twice as high in the breech group. The difference remained significant after intrauterine foetal death and malformations were excluded. Neonatal death was most frequently caused by the respiratory distress syndrome and prematurity, and in the breech group also by intracranial haemorrhage. The difference in perinatal mortality was more pronounced in the low weight and low gestational age groups. At term the differences in mortality between the two groups were small. Neonatal distress assessed as low Apgar score and the need for special care was far more frequent for the breech group. Special care in premature breech deliveries and a liberal use of caesarean section in recommended. Delivery before the 36th week of gestation should be performed by caesarean section.