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Maternal and neonatal outcomes of vaginal breech delivery for singleton term pregnancies in a carefully selected Cameroonian population: a cohort study
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    Pelvimetery and vaginal breech delivery

    Dear Sir,

    It was disappointing to read the recent report on vaginal breech delivery in Cameroon.1 Pelvic assessment was performed clinically. Surely the Faculty of Medicine and Biomedical Science at the University of Yaounde 1 has access to radiological facilities for an erect lateral pelvic X-ray?
    Perhaps the academic debate on pelvimetry in more developed countries has clouded the issue for those in Cameroon. If this is so then the developed world has done little for poorer countries in this area of medicine.
    Joyce et al,2 found that for failed vaginal breech delivery there was a linear relation between the Obstetric conjugate dimension and the fetal size.
    A flat sacrum is important especially if the mid-pelvic AP diameter is narrower than the Obstetric conjugate and the Obstetric conjugate is less than 11.7cms.
    Potter et al.3 studied cases of infants who died of intracranial injury after vaginal breech delivery. In 13 cases maternal pelvic radiographs were available in seven and there was diminished pelvic capacity in all. Beischer4 reviewed the outcome of term breech delivery in 64 patients with pelvic contractions as documented by radiographs. Thirteen patients were delivered by caesarean and all infants survived. In the 51 infants vaginally delivered there were four deaths, three of which were due to tentorial tears. Collea et al.5 performed a study of term frank breech delivery. They randomized patients to vaginal or caesarean delivery...

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    Conflict of Interest:
    None declared.