Breech Presentation

An unfortunate complication of pregnancy may be breech presentation. This is defined as a fetus in a longitudinal lie with buttocks or feet nearest to the cervix. Meaning, labor will be difficult, painful as well as dangerous. As a fetus’ gestational age increases, the likelihood of breech decreases. Some predisposing factors of breech presentation are:

  • Prematurity
  • Uterine malformations
  • Fibroids
  • Polyhydramnios
  • Placenta previa
  • Fetal abnormalities
    • CNS malformations
    • Masses
    • Aneuploidy
  • Multiple gestations.

Fetal deaths are increased with malformations, prematurity and intrauterine fetal demise. So this is a very serious problem and should be detected as soon as possible before labor begins. These are the types of breeches:

  • Frank – 50-70%: hips flexed, knees extended, butt down
    • Pike position
    • Pancake
  • Complete – 5-10%: hips flexed, knees flexed, butt down
    • Cannonball position
  • Footling or incomplete – 10-30%: butt down, thigh flexed, one toe sticks out of cervical os.

 

Figure 1 – Images of the breech presentations.  

Figure 1 – Images of the breech presentations.
 


Source: http://americanpregnancy.org/app/uploads/2012/04/breech_birth.jpg

Pregnant women in Denver should visit the Denver Holistic Center for more information if they have any questions or concerns. Babies naturally move closer and closer to the birth canal as time for delivery comes closer. When the baby’s head is not the part of their body moving towards the birth canal, but is the baby’s buttocks and/or feet, the baby is in breech presentation. About 4% of pregnancies are breech babies. Breech births are also more common in:

  • Subsequent pregnancies
  • Pregnancies of multiples
  • Women with a history of premature delivery
  • Women where the uterus has too much or too little amniotic fluid
    • Polyhydramnios or oligohydramnios
  • Women with an abnormally shaped uterus or with abnormal growths in the uterus
  • Women with a placenta previa.

Between weeks 32 and 37 of pregnancy is when a breech baby should be turned. The medical techniques used are:

  • External version: non-surgical
  • Chiropractic care: reduce stress on pregnant woman’s pelvis leads to relaxation of the uterus and neighboring ligaments

Techniques pregnant women can use at home:

  • Breech tilt: use a large pillow to raise the hips three times a day on an empty stomach when the baby is active
  • Using music: to naturally move the baby

Risks of vaginally delivering the breech baby:

  • Difficult to see the birth canal
  • Cord prolapse

C-section delivery of a breech baby:

  • Especially for premature babies
  • Babies may be too small for vaginal delivery – too much trauma
  • Baby may not have enough weight to stretch the cervix.

These can become serious life-threatening risks, so women should seek medical attention as soon as possible.