Breech Presentation

Facts

Breech presentation occurs when the fetal pelvis or lower extremities engage the maternal pelvic inlet.

Frank breech: the hips are flexed with extended knees bilaterally.

Complete breech: both hips and knees are flexed.

Footling breech: one or both legs are extended below the level of the buttocks.

Risk factors: Preterm gestation, previous breech presentation, uterine abnormality, placental abnormality, amniotic fluid abnormalities (polyhydramnios, oligohydramnios), fetal anomaly, female sex, older maternal age.

Diagnosis: Physical examination and ultrasound.

Treatment:In most cases, spontaneous version may occur at any time before delivery, even after 40 weeks of gestation. If not:  External cephalic rotation before labor, with a trial of labor if the version is successful and cesarean delivery if unsuccessful.

 

Pregnant female reports subcostal discomfort + perceives kicking in the lower abdomen + a soft mass felt in the lower uterine segment on transabdominal examination = Breech Presentation