Breech

Breech Birth is when a baby presentation in the birth canal with the feet or buttocks pointing first.

Can be a serious complication of Childbirth and Pregnancy

A typical finding for a “normal birth” is when the baby is in a head first presentation.

Overall occurs generally between 5-10% of births when at term.

There are different types of breech births as discussed below.

There can be several complications associated with breech birth.

Also, a C-section may be the treatment or alternate if breech birth is not resolved.

 

Causes and/or Risks of a Breech Birth are the following:

–  Premature birth (25%)
–  Increasing size of fetus
–  Change in volume of amniotic fluid
–  Multiple pregnancy (twins, triplets or more)
–  Uterine Abnormalities
–  Caesarean Section on a previous birth
–  Fetal Abnormalities

 

Types of Breech

1.)  Frank Breech

–  Bottom comes first
–  Legs may be flexed at hip
–  Knees extended
–  Generally the most common form – over 60% of the time

2.)  Footling Breech

–  One or both feet come first
–  Common with premature births
–  Uncommon with term births

3.)  Complete Breech

–  Hips and Knees are flexed
–  Sitting cross legged
–  Feet at bottom

4.)  Kneeling Breech

–  Both legs on hips are extended
–  Both knees are flexed
–  May occur with only one flexed knee
–  Occurrence is rare

 

Natural process with a Breech Baby

–  Typically internal rotation occurs by the pelvic floor muscles.
–  The baby will turn so that baby is facing one of the mother’s thighs.
–  The shoulders soon follow the same pattern
–  Next, the baby will rotate to face the mother’s back
–  Baby’s Head should now help the head emerge.
–  Bruising may be found on hips, legs, and genitalia [This will resolve within a few days]

 

Complications associated with Breech Birth:

1.)  Umbilical cord problems such as compression
2.)  Cesarean section may be required
3.)  Loss of oxygen
4.)  Head entrapment
5.)  Neurological problems due to loss of oxygen
6.)  Injury [Brain, arms, legs, hip, etc]
7.)  Abdominal injury
8.)  Others

Breech birth

 

Important factors about Breech Birth:

–  Type of breech
–  Fetal size
–  Maturity
–  Stage of Labor
–  Second twin – if first twin has passed – improved chances for the second
–  Skull size
–  etc

 

Manual attempts in turning baby may be attempted during the first portions of labor

External cephalic version

–  Good results
–  Complications are rare
–  Fetal heart is monitored

 

Importance of C-Section if resolution of breech birth is not immediately realized:

–  When complications arise due to breech, C-Section is often a logical choice.
–  Several risks are associated with a surgery
–  Risks include – internal injury, hysterectomy required, infertility, injury to baby, bleeding, others

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