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DEFLEXION ATTITUDES IN BREECH PRESENTATION

IRVING F. STEIN, M.D.
JAMA. 1941;117(17):1430-1435. doi:10.1001/jama.1941.02820430026007.
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The management of breech presentation has received considerable attention in recent obstetric literature and various plans for delivery have been described with a view to improvement in results. In these contributions, the attack on common practice has been directed against unwarranted haste, premature traction, the abuse of cesarean section and the necessity of anesthesia. All these criticisms, I believe, are on a rational basis. It has been more or less accepted by many authorities on obstetrics that breech presentation is merely a reversed cephalic presentation which can be readily turned by external manipulation, thus obviating the difficulties so often encountered during delivery. Efforts to avoid breech extraction appear to be warranted in view of the fact that the fetal mortality in delivery by breech extraction is from three to five times that by vertex extraction and has been estimated by Rulison1 to claim 14,000 babies annually in the United

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