Induction of labor in breech‐presenting fetuses

We would like to thank Schroll and Krebs for their comments on our manuscript.1 Delivery mode in breech-presenting fetuses will continue be discussed. An expert group from the Norwegian Center of Medical Method Evaluation reviewed literature 2003 concluded that vaginal delivery could advised provided there is a qualified selection, careful birth monitoring presence personnel.2 presented results large hospital 2012-2019 we do agree 11% newborns with 5-minute Apgar score <7 women planned high frequency. The duration expulsive phase longer breech deliveries than cephalic presenting fetuses. It recommended attendant should maintain hands-off position until fetal umbilicus visible then deliver baby active maneuvers.3 Planned implies an increased risk short-term morbidity, low score, umbilical arterial pH compared cesarean section.4 observed <7.05 3.9% births but metabolic acidosis only three (0.6%).5 This means majority had respiratory long-term adverse outcome. association between induced presentations sections In register-based studies, frequency higher labors, this not confirmed randomized probably due confounding by indications.6 did power analysis before investigating population supposed intrapartum section rates 30% spontaneous labors vs 45% labors. actual figures were 46% 48%, respectively, difference was significant after adjusting confounders. most important newborn outcome acidosis, which occurred one 127 among two 479 labors.5 Our objective discuss whether still recommended, compare deliveries. think induction labor acceptable procedure wards practicing accordance recommendations recently published NFOG textbook medical students, states onset optimal, selected patients may feasible.3