Knee-chest postural management for breech at term: A randomized controlledtrial

Background: In 3 to 4 percent of all term births, the fetus presents as a b reech. The objectives of this trial were to assess if assuming the knee-che st position reduced the frequency of breech presentation at delivery, incre ased the success of the subsequent external cephalic version, or both, and to determine if this management plan reduced the need for cesarean delivery . Methods: A randomized clinical trial recruited 100 women from two hospita ls in Adelaide, South Australia, with a singleton breech presentation and a gestational age equal to or more than 36 weeks. Women in the treatment gro up were advised to assume the knee-chest position for 15 minutes three time s a day for one week. Women in the control group did not perform postural m anagement All participants were reviewed one week later and women whose bab y remained as a breech presentation were offered an external cephalic versi on. Results: Postural management did not increase the success of the extern al cephalic version, reduce the frequency of breech presentation at deliver y, or reduce the need for cesarean delivery in women with a breech presenta tion at tent. Conclusions: Findings from this trial included in a meta-anal ysis of postural management for breech presentation at term suggested that this is not an effective form of care to be offered routinely to women with a breech presentation at term.