What is Breech Presentation?
Breech presentation refers to the position of the fetus where the buttocks or feet are positioned to be delivered first instead of the head. This is a relatively common situation, occurring in about 3-4% of full-term pregnancies. While most babies are in a head-down position by the time of delivery, some remain in a breech position for various reasons.
Types of Breech Presentation
There are three primary types of breech presentations:
1.
Frank Breech: The baby's buttocks are aimed at the birth canal with legs sticking straight up in front of the body, and the feet near the head.
2.
Complete Breech: The baby's buttocks are pointing downward with the legs folded at the knees and feet near the buttocks.
3.
Footling Breech: One or both of the baby's feet are positioned to deliver first.
Causes of Breech Presentation
Several factors might contribute to a breech presentation:
- Prematurity: Babies born prematurely have a higher likelihood of being in a breech position.
-
Uterine Abnormalities: Abnormalities in the shape of the uterus can restrict the baby’s ability to turn into a head-down position.
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Polyhydramnios or Oligohydramnios: Too much or too little amniotic fluid can prevent the baby from moving into the correct position.
-
Multiple Pregnancies: Carrying more than one baby can limit space, making it difficult for babies to turn head-down.
- Placenta Previa: The placenta partially or wholly covers the cervix, blocking the baby from moving into a head-down position.
Diagnosis of Breech Presentation
Breech presentation is often diagnosed through physical examination and confirmed via
ultrasound. During a physical exam, the healthcare provider may feel the baby's head in the upper part of the uterus. Ultrasound provides a clear image of the baby's position and helps in planning the delivery.
Management of Breech Presentation
Management strategies include:
-
External Cephalic Version (ECV): A procedure where the healthcare provider attempts to turn the baby into a head-down position by applying pressure on the mother’s abdomen.
- Planned
Cesarean Delivery: Often recommended if the ECV is unsuccessful or not feasible, as it is generally safer for both mother and baby.
- Vaginal Breech Delivery: In certain cases and under specific conditions, a vaginal breech delivery may be attempted, but it carries higher risks and requires an experienced obstetrician.
Risks Associated with Breech Presentation
Breech presentation can pose several risks:
- During a vaginal breech delivery, there's an increased risk of umbilical cord prolapse, which can lead to oxygen deprivation.
- The baby’s head, being the largest part, might get stuck during delivery.
- Increased chances of birth injuries due to the delivery of the body before the head.Preventive Measures and Recommendations
While not all breech presentations can be prevented, certain measures might help:
- Regular prenatal check-ups to monitor the baby's position.
-
Pelvic Tilts and other exercises recommended by healthcare providers may help in turning the baby.
- Discussing all available options with a healthcare provider to understand the risks and benefits of each delivery method.
Conclusion
Breech presentation is a complex situation that requires careful management to ensure the safety of both mother and baby. Understanding the types, causes, diagnosis, management options, and associated risks can significantly aid in making informed decisions regarding delivery. Always consult with a healthcare provider for the best course of action tailored to individual circumstances.
