• Aaron B Deutsch, Karen Duncan, Lakshminarayan Rajaram, Hamisu M Salihu, William N Spellacy, and Victoria Belogolovkin.
• Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of South Florida College of Medicine, Tampa, FL 33606, USA. abdmd2003@hotmail.com
• J. Matern. Fetal. Neonatal. Med. 2011 Mar 1; 24 (3): 475-9.

ObjectiveTo determine how United States Maternal-Fetal medicine specialists recommend delivery of a breech fetus at the threshold of viability.MethodsU.S. Society for Maternal-Fetal Medicine (SMFM) members were surveyed about; geographic location, practice type, whether they performed deliveries, definition of threshold for viability, recommendations for delivery of a breech fetus at the threshold of viability, and if the current medical-legal climate had any bearing on their decisions. Chi-Square and Fisher's Exact tests were used for analysis.Results510 SMFM members responded to the questionnaire. The highest percentage of respondents stated '23 weeks' (31%) as the cutoff for viability, followed by '24 weeks' (21%) and '23 weeks or 500 g' (10%). Seventy percent recommended cesarean delivery for a breech fetus at the threshold of viability. The majority of respondents based their decision on 'published data' or 'expert opinion', however, 58.6% reported they felt current medical evidence was inadequate to support a recommendation. Fifty-three percent stated their recommendations are affected by medical-legal concerns.ConclusionThe majority of U.S. maternal fetal-medicine specialists who responded would recommend cesarean delivery for a breech fetus at the threshold of viability, despite the belief that there is inadequate evidence in the literature to support this recommendation.

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