What is a maternal or fetal contraindication for vaginal delivery in breech presentations?

The presence of fetal weight being either less than 2500 g or greater than 4000 g constitutes a maternal or fetal contraindication for vaginal delivery in breech presentations. This is important because low birth weight (under 2500 g) can indicate prematurity or an underdeveloped fetus, which can increase the risks associated with a breech delivery. A fetus over 4000 g, or large for gestational age, poses significant risks due to the potential for delivery complications, including shoulder dystocia and increased chances of emergency cesarean section.

In breech presentations, the ideal scenario is to have a fetus that is within an optimal weight range, generally believed to be between these limits. The risks associated with management can escalate with either extremely low or high fetal weights, making it crucial to approach these situations with caution concerning vaginal delivery.

In contrast, the availability of skilled staff for breech delivery and intermittent fetal monitoring are not definitive contraindications. A trained team can manage a breech delivery under controlled conditions with the right measures in place. The degree of hip and knee flexion does not significantly impact the decision-making process regarding the safety of vaginal delivery in these cases.