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Article
February 2, 1957

MANAGEMENT OF THE FIRST STAGE OF LABOR IN BREECH PRESENTATION

JAMA. 1957;163(5):331-332. doi:10.1001/jama.1957.02970400003002
Abstract

• The death rate in breech-presenting babies is unexplainably high and can be lowered. The findings, the sequence of events, and the criteria of progress familiar in cephalic presentations are not completely applicable to breech presentations. One must sit with the patient, and progress must be judged by frequent rectal examination, auscultation, and abdominal palpation. The deliberate rupturing of the membranes and the administration of oxytocin are not recommended. The condition and effacement of the cervix must be correctly interpreted. Roentgenographic study of fetus and pelvis are almost routine. Prolapse of the cord is the complication most likely to cause fetal distress or intrapartum fetal death. A more thorough recording of the indications in each case of cesarean section would help to evaluate the usefulness of this operation in breech deliveries. Data on all fetal or maternal abnormalities associated with breech delivery are needed to help explain the death rate in this condition.

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