Breech Presentation
Breech presentation occurs when the fetus is in a longitudinal lie but the buttocks or feet, rather than the head, are presenting at the maternal pelvic inlet. It complicates approximately 3–4% of term pregnancies.
Types of Breech
- Frank Breech: Hips flexed, knees extended (most common).
- Complete Breech: Hips and knees both flexed.
- Footling (Incomplete) Breech: One or both feet presenting (highest risk of cord prolapse).
Management Options
| Intervention | Description |
|---|---|
| ECV | External Cephalic Version: Attempting to turn the fetus to a cephalic presentation manually after 36–37 weeks. |
| Planned CS | The standard of care for most term breech pregnancies to avoid birth trauma and complications. |
High-Yield Exam Pearl:
- Contraindications to ECV: Multiple gestation, placenta praevia, prior classical CS, or non-reassuring fetal heart rate tracing.
- Head Entrapment: The most significant risk during vaginal breech delivery, occurring when the after-coming head is stuck in the pelvis, often because the body is born before the cervix is fully dilated.