Breech Presentation

Question 1

What are risk factors for breech presentation?

Answer 1

SGA
Polyhydraminos
Multiple pregnancy
Uterine malformations e.g. fibroids
Prematurity
Placenta praevia
Foetal abnormality

Question 2

What are the different types of breech presentation?

Answer 2

Frank- hips flexed knees extended
Complete- hips and knees flexed
Footling- one or both feet presenting first

Question 3

What is the management?

Answer 3

<36 weeks
- often turns spontaneously

> 36 weeks nulli or >37 weeks multi
-ECV is offered
- If failed then decision made re attempt vaginal delivery or C section

Question 4

What are complications of breech development?

Answer 4

Foetal head entrapment
Umbilical cord prolapse
Birth trauma
Perinatal asphyxia

Question 5

What are absolute contra-indications to ECV?

Answer 5

If C section required
APH within past 7 days
Abnormal CTG
Major uterine abnormality
Ruptured membranes
Multiple pregnancy