Sir: In the emotionally charged debate about Caesarean sections, I am alarmed to see that Professor Horner states that the treatment of choice for breech presentation is Caesarean section (letter, 10 March).
Routine Caesarean section for the term breech foetus is not justified by the available data. It is one of several treatment interventions available, the others including selected vaginal breech delivery or external cephalic version at term.
The effectiveness of this latter procedure is demonstrated by clear evidence from controlled trials, and the Royal College of Obstetricians and Gynaecologists has suggested that units audit their success in achieving the standard that "all women at term with an uncomplicated pregnancy in breech presentation should be offered external cephalic version".
We have a duty to provide our patients with reliable accurate information about options available to them, so they can make a fully informed choice.
Consultant Obstetrician and Gynaecologist
Douglas, Isle of ManReuse content