Induction of labor in breech presentation

Objective: Induction of labor in breech presentation, although not contrain dicated, has rarely been reported. We have undertaken to evaluate the safet y and outcome of this practice in two Israeli institutions along with a lit erature review of this controversial subject. Method: The research design w as a retrospective case control study covering the years: 1980-1999. We hav e studied 53 term (> 3T weeks) breech deliveries induced for various medica l and obstetrical reasons, in two major regional hospitals in Israel. Induc tion was performed with prostaglandin E-2 for the unripe cervix and with ox ytocin for induction or augmentation when the cervix was ripe. Six women we re induced by nipple stimulation, Controls were 53 women with spontaneous l abor in breech presentation that had a trial of vaginal delivery, and 54 wo men with breech presentation who delivered by elective cesarean section. Re sult: No significant difference in the various maternal and fetal outcomes was observed. CS rate was comparable in both study and control groups (34% vs. 32%) and two-thirds gave birth vaginally. Conclusions: In properly sele cted and carefully managed cases of breech presentation, induction of labor seems a safe and reasonable option. (C) 2001 International Federation of G ynecology and Obstetrics. All rights reserved.