Guide | Breech Presentation: Causes and Management
As the fetus grows late in pregnancy, space for movement in the uterus decreases. Most fetuses naturally turn head-down in preparation for delivery through the birth canal. Some remain breech, with the head up and the buttocks or feet positioned to emerge first. Breech delivery carries more risk than head-first delivery and requires specialized medical care.
What is breech presentation?
Most fetuses turn head-down before delivery, the most common and safest birth position. In breech presentation, the buttocks or feet emerge before the head. This is challenging for obstetricians and involves greater risk and complexity.
If delivery is successful, breech babies generally have no long-term health problems and grow and develop like other children. A transverse lie, in which the fetus lies sideways in the uterus, requires cesarean delivery.
Causes of breech presentation
Breech presentation is common early in pregnancy, but most fetuses turn head-down by 36 to 37 weeks. About 3%–4% remain breech at term. Factors that increase the likelihood include:
First pregnancy
Too little or too much amniotic fluid
Placenta previa
Multiple pregnancy
Signs of breech presentation
Breech presentation does not change the general pregnancy experience, and early symptoms such as nausea and vomiting are the same. The patient may feel kicks lower in the abdomen and a firm lump, the fetal head, near the ribs. A clinician can assess fetal position by palpation, and ultrasound can confirm it.
Can a breech fetus be turned?
At around 36 weeks, a doctor may recommend external cephalic version (ECV), applying pressure to the abdomen to turn the fetus head-down. The procedure is considered safe but may cause mild discomfort. If successful, vaginal delivery may be possible.
ECV succeeds in about 50% of cases. Even after a successful version, clinicians may recommend preparing for a cesarean delivery in case an emergency occurs during labor.
Delivery options
Near the due date, discuss delivery options with your doctor. The usual choices are vaginal breech birth and planned cesarean delivery. A planned cesarean is generally safer for the baby. If vaginal delivery is chosen, it should take place in a fully equipped hospital in case an emergency cesarean is needed.
Doctors may advise against vaginal delivery in situations such as footling breech presentation, unusually high or low fetal weight, or pregnancy complications.
Cesarean delivery for breech presentation
In most cases, a planned cesarean at 39 weeks is recommended to allow the baby's lungs to mature. If labor begins before the scheduled procedure, the doctor will assess whether to proceed with cesarean or vaginal delivery.
Although cesarean delivery is safer for the baby, maternal risks include excessive bleeding, postoperative infection, and a greater likelihood of cesarean delivery in future pregnancies.
Risks of breech birth
The most dangerous complication is entrapment of the fetal head in the birth canal after the body has emerged. Compression or prolapse of the umbilical cord can interrupt oxygen delivery and cause severe brain injury.
Breech babies are also more likely to have developmental dysplasia of the hip, which can cause hip dislocation. Hip ultrasound at 4 to 6 weeks after birth may be needed for diagnosis.
Conclusion
A fully equipped hospital is essential for safe breech delivery. Whether delivered vaginally or by cesarean, most breech babies grow and develop normally without long-term health effects.
Guide | Breech Presentation: Causes and Management
Guide | Breech Presentation: Causes and Management
As the fetus grows late in pregnancy, space for movement in the uterus decreases. Most fetuses naturally turn head-down in preparation for delivery through the birth canal. Some remain breech, with the head up and the buttocks or feet positioned to emerge first. Breech delivery carries more risk than head-first delivery and requires specialized medical care.
What is breech presentation?
Most fetuses turn head-down before delivery, the most common and safest birth position. In breech presentation, the buttocks or feet emerge before the head. This is challenging for obstetricians and involves greater risk and complexity.
If delivery is successful, breech babies generally have no long-term health problems and grow and develop like other children. A transverse lie, in which the fetus lies sideways in the uterus, requires cesarean delivery.
Causes of breech presentation
Breech presentation is common early in pregnancy, but most fetuses turn head-down by 36 to 37 weeks. About 3%–4% remain breech at term. Factors that increase the likelihood include:
First pregnancy
Too little or too much amniotic fluid
Placenta previa
Multiple pregnancy
Signs of breech presentation
Breech presentation does not change the general pregnancy experience, and early symptoms such as nausea and vomiting are the same. The patient may feel kicks lower in the abdomen and a firm lump, the fetal head, near the ribs. A clinician can assess fetal position by palpation, and ultrasound can confirm it.
Can a breech fetus be turned?
At around 36 weeks, a doctor may recommend external cephalic version (ECV), applying pressure to the abdomen to turn the fetus head-down. The procedure is considered safe but may cause mild discomfort. If successful, vaginal delivery may be possible.
ECV succeeds in about 50% of cases. Even after a successful version, clinicians may recommend preparing for a cesarean delivery in case an emergency occurs during labor.
Delivery options
Near the due date, discuss delivery options with your doctor. The usual choices are vaginal breech birth and planned cesarean delivery. A planned cesarean is generally safer for the baby. If vaginal delivery is chosen, it should take place in a fully equipped hospital in case an emergency cesarean is needed.
Doctors may advise against vaginal delivery in situations such as footling breech presentation, unusually high or low fetal weight, or pregnancy complications.
Cesarean delivery for breech presentation
In most cases, a planned cesarean at 39 weeks is recommended to allow the baby's lungs to mature. If labor begins before the scheduled procedure, the doctor will assess whether to proceed with cesarean or vaginal delivery.
Although cesarean delivery is safer for the baby, maternal risks include excessive bleeding, postoperative infection, and a greater likelihood of cesarean delivery in future pregnancies.
Risks of breech birth
The most dangerous complication is entrapment of the fetal head in the birth canal after the body has emerged. Compression or prolapse of the umbilical cord can interrupt oxygen delivery and cause severe brain injury.
Breech babies are also more likely to have developmental dysplasia of the hip, which can cause hip dislocation. Hip ultrasound at 4 to 6 weeks after birth may be needed for diagnosis.
Conclusion
A fully equipped hospital is essential for safe breech delivery. Whether delivered vaginally or by cesarean, most breech babies grow and develop normally without long-term health effects.
Source:
Compiled from online sources