Breech Delivery and Updates in Simulation for Breech Vaginal Delivery

The incidence of breech presentation at term is approximately 3–4%. In the United States, more than 85% of pregnant women with persistent breech presentation are delivered by cesarean delivery. The Term Breech Trial, published in 2000, reported an increased risk of short-term complications in singleton breech vaginal deliveries. More recent evidence, however, has refuted these findings. In select patients, planned vaginal delivery of the breech-presenting fetus is encouraged by several professional societies today. The aim of this chapter is to provide an evidence-based overview of breech vaginal delivery in both term and preterm pregnancies, including a comprehensive review of the Term Breech Trial and its impact worldwide. Technique for breech vaginal delivery is discussed in detail, as well as current trends in obstetrics simulation for breech delivery.