Overview of issues related to breech presentation
- G Justus Hofmeyr, MD
G Justus Hofmeyr, MD
- University of the Witwatersrand
- University of Fort Hare, South Africa
Breech presentation describes the fetus whose buttocks are adjacent to the birth canal. This topic will provide an overview of major issues related to breech presentation, including the best approach for delivery. Techniques for breech delivery are discussed separately. (See "Delivery of the fetus in breech presentation".)
TYPES OF BREECH PRESENTATION
The main types of breech presentation are:
●Frank breech – In the frank breech position, both hips are flexed and both knees are extended so that the feet are adjacent to the fetal head (figure 1). At term, 50 to 70 percent of breech fetuses are in this position.
●Complete breech – In the complete breech position, both hips and both knees are flexed (figure 2). At term, 5 to 10 percent of breech fetuses are in this position.
●Incomplete breech – In the incomplete breech position, one or both hips are not completely flexed (figure 3). At term, 10 to 40 percent of breech fetuses are incomplete.
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- TYPES OF BREECH PRESENTATION
- RISK FACTORS
- Risk of recurrence
- CLINICAL FINDINGS AND COURSE
- Physical examination
- Natural history
- DIAGNOSTIC EVALUATION
- CHOOSING THE ROUTE OF DELIVERY AT TERM
- External cephalic version with cesarean delivery of the persistent breech
- External cephalic version with vaginal breech delivery for selected patients with a persistent breech
- Cesarean delivery without an attempt at external cephalic version
- Vaginal delivery without an attempt at external cephalic version
- Guidelines from selected organizations
- CHOOSING THE ROUTE OF PRETERM DELIVERY
- TECHNIQUE FOR BREECH DELIVERY
- NEONATAL OUTCOME
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS