Obstet Gynecol. 2018 Aug;132(2):531-532. doi: 10.1097/AOG.0000000000002756.
There is a trend in the United States to perform cesarean delivery for term singleton fetuses in a breech presentation. The number of practitioners with the skills and experience to perform vaginal breech delivery has decreased. The decision regarding the mode of delivery should consider patient wishes and the experience of the health care provider. Obstetrician-gynecologists and other obstetric care providers should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, desires a planned vaginal delivery of a vertex-presenting fetus, and has no contraindications. External cephalic version should be attempted only in settings in which cesarean delivery services are readily available. Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for eligibility and labor management. If a vaginal breech delivery is planned, a detailed informed consent should be documented-including risks that perinatal or neonatal mortality or short-term serious neonatal morbidity may be higher than if a cesarean delivery is planned.
在美国，有一种趋势是为足月臀位单胎胎儿行剖宫产。能够实施阴道臀位分娩的医生数量有所减少。分娩方式的选择应考虑患者的意愿和医疗保健提供者的经验。妇产科医生和其他产科护理提供者应为有意愿计划阴道分娩头位胎儿且无剖宫产禁忌证的足月臀位单胎胎儿的妇女提供经阴道外倒转术（ECV），以替代计划剖宫产。仅在可随时提供剖宫产服务的环境中尝试经阴道外倒转术。在符合医院特定的纳入标准和分娩管理方案的情况下，计划阴道分娩足月臀位单胎胎儿可能是合理的。如果计划行阴道臀位分娩，应详细记录知情同意书，包括围产儿或新生儿死亡率或短期严重新生儿发病率可能高于计划剖宫产的风险。
