Current guidelines for management of breech presentation: a comparative review of Royal College of Obstetricians and Gynaecologists, American College of Obstetricians and Gynecologists and the Federation of Obstetric and Gynaecological Societies of India recommendations
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20261653Keywords:
Breech presentation, ECV, RCOG, ACOG, FOGSI, Vaginal breech delivery, GuidelinesAbstract
Breech presentation remains a significant obstetric challenge, with variations in management strategies across different professional bodies. Clinical decisions are influenced by evolving evidence and institutional preferences. This review is aimed to compare and analyze current recommendations for the management of breech presentation from Royal College of Obstetricians and Gynaecologists (RCOG), the American College of Obstetricians and Gynecologists (ACOG), and the Federation of Obstetric and Gynaecological Societies of India (FOGSI). A narrative review of published guidelines and official recommendations from RCOG, ACOG, and FOGSI was conducted. Key domains analyzed included external cephalic version (ECV), criteria for vaginal breech delivery, intrapartum management, and indications for caesarean section. All three organizations support ECV as a first-line intervention in eligible women. While ACOG and RCOG permit planned vaginal breech delivery under strict selection criteria, FOGSI emphasizes institutional capability and clinician expertise. Differences exist in patient selection, intrapartum monitoring, and thresholds for caesarean delivery. Although core principles remain consistent, variations in recommendations reflect regional practices and medico-legal considerations. Standardization and skill-based training are essential to optimize outcomes in breech presentation.
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