Use of forceps - As mentioned above, some obstetricians prefer to use forceps to assist delivery of the aftercoming head. A review of 90 textbooks observed that recommendations for safe intervals between birth of the and the head ranged from 5 to 20 minutes. Gestational age ≥36 weeks – The preterm fetus has a greater ratio of fetal head circumference to abdominal circumference (HC/AC) than a term fetus, but the gestational age at which the risk of head entrapment is increased is not well defined 7 minutes or umbilicus to head birth >3 minutes was associated with poor perinatal outcomes.(See "Choosing the route of delivery after cesarean birth".) French guidelines do not consider a previous cesarean a contraindication to the trial of labor. Whether the prior cesarean was for a probable recurring indication is a factor in balancing the risks and benefits of a trial of labor. No prior cesarean births – Prior cesarean is a relative contraindication, based on expert opinion, since both vaginal breech birth and trial of labor after a previous cesarean are associated with increased risk.There is no convincing evidence that pelvimetry (clinical or radiographic ) in patients with breech presentation provides information that leads to better patient selection for a trial of labor and vaginal birth or improved neonatal outcome however, few data are available from large or randomized trials. Although a contracted pelvis with fetal-pelvic disproportion is a contraindication to vaginal birth, making an accurate diagnosis is not possible in most cases. ![]()
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