Breech presentation

The breech is the bottom end of the fetus. Prior to the last month of pregnancy, the fetus is very active and assumes many positions. Towards the end of the pregnancy the head presents into the pelvis. In about 3% of pregnancies the baby still presents by the breech, posing a dilemma regarding the route of delivery for the baby. We classify breech into three types, because their management is different.

The extended breech is least likely to turn, whereas the flexed breech is most likely to turn to cephalic, either spontaneously or with the use of external cephalic version (ECV). The footling breech can cause problems if the membranes break, as the foot will not fit the pelvis (and the cord can prolapse down). The most recent randomised studies indicate that the best route for delivering a baby presenting by the breech is by Caesarean Section. Furthermore, as more and more breech deliveries are by Caesarean section, it is important when considering a vaginal approach to ascertain the level of experience of the attending care who will assist you with your breech delivery.