Introduction: Delivery with foetus in breech presentation carries a dilemma for obstetrician concerning the method of choice which would be the best for the foetus and the mother. Goal: The aim of this study was to analyse the frequency of breech presentation, mode of delivery and the methods of manual assistance concerning the Apgar score of the children at delivery. Method: Study involved all women with a child in breech position who gave birth in the Institute for Gynaecology and Obstetrics of the Clinical Centre of Serbia in Belgrade during the period of six years. Results: Frequency of the breech presentation in the investigated period was 4.5%. In the last three years children in breech presentation are delivered more often by caesarean section (2.7-3.1%) than vaginally (1.6-1.7%). In vaginal deliveries manual assistance by Bracht/Lowset was performed most often- in 70.5%. At the second place is manual assistance by Bracht- in 18, 2%. Feet extraction of the foetus is performed in 4.4% of deliveries. The frequency of Smeli-Veit assistance is 6.7%, while the Forceps was used in 0.3% of cases. High Apgar score from 8-10 have foetuses born using the methods of assistance by Bracht/Lowset and Bracht (83 85%) with high statistical significance in comparison with other three methods of manual assistance (p<0.001). There is no statistical significance concerning Apgar score between the methods of Bracht/Lowset and Bracht (p=0.59). Conclusion: By using the adequate manual assistance which is the least traumatic for the foetus we achieve better postnatal prognosis. 

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