Breech Presentation

Question 1

What are RFs for a breech presentation?

Answer 1

uterine malformations, fibroids
placenta praevia
polyhydramnios or oligohydramnios
fetal abnormality (e.g. CNS malformation, chromosomal disorders)
prematurity (due to increased incidence earlier in gestation)

Question 2

What condition is more common in breech presentations?

Answer 2

Cord prolapse

Question 3

How is a breech presentation managed?

Answer 3

If under 36 weeks, see if fetus naturally turns

At 36 weeks, trial external cephalic version (60% success) - offered at 36 weeks to nulliparous women, 37 weeks for multiparous

If baby still in breech, plan caesarean or attempt vaginal delivery

Question 4

What are the risks and benefits of a planned caesarean to mother and baby?

Answer 4

planned caesarean section carries a reduced perinatal mortality and early neonatal morbidity for babies with a breech presentation at term compared with planned vaginal birth

Question 5

What are absolute contraindications to ECV

Answer 5

where caesarean delivery is required
antepartum haemorrhage within the last 7 days
abnormal cardiotocography
major uterine anomaly
ruptured membranes
multiple pregnancy