Assisted vaginal breech delivery
First stage of labour
Cervical dilatation and descent of the presenting part should be plotted on the partogram for early identification of abnormal progress. If the first stage is uneventful and normally progressive then a safe vaginal breech delivery could be anticipated. The role of oxytocin augmentation for dysfunctional labour is debatable and less favoured. Continuous electronic fetal monitoring should be employed. Umbilical cord prolapse or entanglement is more common with breech presentation and should be excluded by pelvic examination once the membranes are ruptured or if there is any cardio- tocographic abnormality. Appearance of meconium before the fetus is in the pelvis is not 'normal' and should be considered as a possible sign ofdistress. It is often possible for the legs to appear at the introitus through an incompletely dilated cervix. It is vitally important to ensure that the cervix is fully dilated and retracted before any attempt at vaginal delivery is made. If delivery is attempted through an undilated cervix the disastrous consequence of fetal head entrapment can occur.