Definition of Breech Birth
Breech birth refers to the delivery of a baby in a position other than the common head-first presentation. In a breech presentation, the baby’s buttocks or feet are positioned to come out of the birth canal first, rather than the head. This occurs in approximately 3-4% of singleton pregnancies near term.
Types of Breech Presentations
There are three main types of breech presentations:
- Frank Breech: This is the most common type of breech presentation, where the baby’s buttocks are positioned to come out first, with the knees flexed and the feet near the head.
- Complete Breech: In this presentation, the baby sits cross-legged, with both knees and hips flexed, making the buttocks and feet the presenting part.
- Footling Breech: This type occurs when one or both feet extend down into the birth canal, making them the first part to be visible during delivery.
Causes of Breech Presentation
The exact cause of breech presentation is often unknown, but there are several factors that can increase the likelihood of a breech birth:
- Multiple pregnancies (e.g., twins or triplets)
- Prior breech birth
- Premature birth
- Uterine abnormalities
- Too little or too much amniotic fluid
- Placenta previa (when the placenta partially or completely covers the cervix)
- Fetal abnormalities affecting space within the uterus
Risks and Complications
Breech births are associated with certain risks and complications, including:
- Cord prolapse (umbilical cord exits before the baby)
- Head entrapment (the head gets stuck during delivery)
- Birth injuries, such as hip dysplasia or bone fractures
- Delayed lung development
- Intrauterine growth restriction (poor fetal growth)
- Low Apgar scores (lower than normal newborn assessment scores)
Management and Delivery
The management of a breech birth depends on various factors, including the specific type of breech presentation, the mother’s health, and the gestational age of the baby.
If a breech presentation is detected earlier in pregnancy, interventions like external cephalic version (ECV) may be attempted, which involves manually turning the baby into a head-down position. However, if the pregnancy is near term and ECV is unsuccessful or not suitable, a cesarean section (C-section) delivery is often recommended to ensure the safest outcome for both the mother and baby.
It is important for healthcare professionals to carefully assess and monitor breech presentations to decide on the most appropriate course of action, taking into account individual circumstances and the best interests of the mother and baby.