What is a Complete Breech?
A complete breech is a type of breech presentation where the baby is positioned with its buttocks down, and its knees are bent with feet near the buttocks. This differs from other breech presentations such as the frank breech, where the baby's legs are straight up in front of its body, and the footling breech, where one or both of the baby's feet are positioned to deliver first.
How Common is Complete Breech?
Breech presentations occur in about 3-4% of full-term pregnancies. Of those, a complete breech presentation is less common compared to the frank breech. The likelihood of a baby being in a breech position decreases as the pregnancy progresses, with most babies turning head down by the 37th week.
What Causes Breech Presentation?
There are various factors that can lead to a breech presentation. These include prematurity, uterine abnormalities such as fibroids or a bicornuate uterus, excessive amniotic fluid, multiple pregnancies, and placenta previa. Sometimes, it may simply be due to the baby having more room to move around early in the pregnancy and not turning head down later.
How is Complete Breech Diagnosed?
A complete breech can be diagnosed through a combination of physical examination and imaging techniques. During a physical exam, healthcare providers may feel the baby's position through the mother's abdomen. An ultrasound can provide a clearer image of the baby’s position. In some cases, a pelvic exam may also confirm the presentation.
What are the Risks and Complications?
A complete breech presentation is associated with several risks and complications during delivery. These include umbilical cord prolapse, where the cord slips into the birth canal ahead of the baby, leading to decreased oxygen supply, and head entrapment, where the baby's head gets stuck during delivery. Additionally, there is an increased risk of birth injuries and asphyxia.
What are the Management Options?
Management of a complete breech presentation varies based on the gestational age and the specific circumstances of the pregnancy. Options include:
- External Cephalic Version (ECV): This is a procedure where a healthcare provider attempts to turn the baby to a head-down position by applying pressure on the mother's abdomen. ECV is usually performed around 37 weeks of gestation.
- Planned Cesarean Section: Given the risks associated with vaginal breech delivery, a cesarean section is often recommended. This method is considered safer for both the mother and baby in many cases.
- Vaginal Breech Delivery: In select cases, vaginal delivery may be attempted, but it requires careful consideration of the mother's and baby's conditions, the experience of the healthcare team, and the availability of facilities to handle emergencies.
Can Breech Presentation be Prevented?
There is no guaranteed way to prevent a breech presentation, but some practices may help. Maintaining a healthy pregnancy, attending regular prenatal check-ups, and following a balanced diet and exercise routine can contribute to optimal fetal positioning. Some practitioners recommend techniques such as the
Webster Technique or
moxibustion, though their effectiveness varies.
When to Seek Medical Advice?
If you are in your third trimester and suspect your baby may be in a breech position, it is essential to consult your healthcare provider. They can confirm the baby’s position and discuss the best course of action. Early detection and appropriate management can significantly improve outcomes for both mother and baby.
