The management of breech pregnancies in Australia and New Zealand

AIM: To assess current obstetric practice in the management of singleton breech pregnancies in Australia and New Zealand. METHODOLOGY: Survey mailed to all members and fellows of the Royal Australian and New Zealand College of Obstetrics and Gynaecology. RESULTS: Of 1284 surveyed, 956 (74%) responded of whom 696 (73%) were practicing obstetrics. Prior to the Term Breech Trial (TBT), 72% of obstetricians reported that they routinely offered vaginal breech birth for uncomplicated singleton breech pregnancies. After the TBT publication this rate declined to 20%. External cephalic version (ECV) was usually recommended by 67% of obstetricians and only 53% use tocolytics. Common practices for which safety has yet to be demonstrated included 28% of obstetricians carrying out ECV outside hospitals and 42% carrying out ECV before 37 weeks' gestation. CONCLUSIONS: While the majority of obstetricians recommend ECV and/or planned Caesarean section for breech presentation, barriers to the promotion of ECV and the use of tocolysis for ECV need to be identified if the rates of this effective manoeuvre are to be increased.