Zatuchni and Andros developed a prognostic scoring index to evaluate women at term with a breech presentation. This can help determine which patients should undergo caesarean section and which can undergo vaginal delivery.
Patient selection: singleton pregnancy at term with breech presentation
Parameters:
(1) parity
(2) gestational age in weeks
(3) estimated fetal weight
(4) number of previous breech deliveries
(5) cervical dilatation in cm
(6) station
|
Parameter |
Finding |
Points |
|
parity |
0 |
0 |
|
|
>= 1 |
1 |
|
gestational age in weeks |
37 |
2 |
|
|
38 |
1 |
|
|
39 |
0 |
|
estimated fetal weight |
<= 3,175 grams (< 7 lbs) |
2 |
|
|
3,176 to 3,629 grams (7-8 lbs) |
1 |
|
|
>= 3,630 grams (> 8 lbs) |
0 |
|
number of previous breech deliveries |
0 |
0 |
|
|
1 |
1 |
|
|
>= 2 |
2 |
|
cervical dilatation |
<= 2 cm |
0 |
|
|
3 cm |
1 |
|
|
>= 4 cm |
2 |
|
station |
-3 or higher |
0 |
|
|
-2 |
1 |
|
|
-1 or lower |
2 |
where:
• The gestational age is limited to term deliveries.
total index =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 11
• The higher the score the better the chances of a vaginal delivery.
• A score <= 3 is an indication for cesarean section because of excessive perinatal morbidity and mortality. A score > 3 indicates that vaginal delivery is feasible.
Specialty: Obstetrics & Gynecology
ICD-10: ,
