Vaginal delivery of breech presentation (VBD) was always a subject for debate among obstetricians worldwide but is possible in France providing that safety criteria are filled (the PREMODA study by Goffinet et al 2008). Maneuvers during VBD are hardly ever used, firstly because of the rare occurrence of breech presentation, and secondly because there are no guidelines clearly defining their indications. The objective of our study was to identify factors associated to systematic maneuvers in eutocic VBD and a potential effect of these maneuvers on neonatal and maternal outcomes. Material and Methods Data were extracted from the PREMODA database (Goffinet et al, 2008). Patients presenting a VBD were included into two groups: 626 women in the group without manoeuvers (WM) and 537 in the group with systematic maneuvers (SM). Women who had maneuvers for dystocic obstetrical situation, like head retention and/or arm extension, were excluded. Maternal, institutional, fetal and neonatal characteristics were compared to identify factors associated to systematic maneuvers and neonatal outcomes. Results Concerning maternal and neonatal outcomes, no difference between groups were noted except for umbilical cord arterial pH measurement, which was lower in the SM group (7.25±0.1 Vs. 7.27±0.1, p=0.01), and 1st and 2nd maternal perineal tears, which were more often observed in SM group (85.7% Vs. 78.2%, p=0.002) (Table 1). Factors associated with systematic maneuvers were: first vaginal delivery (OR=1.65, CI95%[1.30,2.09], p<0.001), non-Caucasian ethnic origin (OR=2.07, CI95%[1.41,3.05], p<0.001), secondary and post-secondary educational school level (OR=1.51, CI95% [1.06,2.17], p=0.02), delivery at a level 2B or 3 maternal health care hospital (OR=1.74, CI95%[1.16,2.62], p=0.008 and OR=1.87, CI95%[1.22,2.85], p=0.004, respectively), the presence of a junior or senior obstetrician at the moment of delivery (OR=5.12, CI95%[1.69,15.5], p=0.004 and OR=4.57, CI95%[2.33,8.97], p<0.001, respectively), and a passive phase of ...