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2 results

  • Case 49 - A 30-Year-Old at 36 Weeks’ Gestation with Breech Presentation

  • from Section 6 - Intrapartum/Delivery
  • Edited by Peter F. Schnatz, The Reading Hospital, Pennsylvania, D. Yvette LaCoursiere, University of California, San Diego, Christopher M. Morosky, University of Connecticut School of Medicine, Jonathan Schaffir, The Ohio State University College of Medicine, Vanessa Torbenson, Mayo Clinic Alix School of Medicine, David Chelmow, Virginia Commonwealth School of Medicine
  • Book:
    Pregnancy Complications
    Published online:
    08 April 2025
    Print publication:
    01 May 2025, pp 149-151

  • Summary

    This is a case presentation of a nulliparous patient at 36 weeks’ gestation, noted to have a fetus in a frank breech presentation. This case discusses the diagnosis, treatment, planning, and management of the breech fetus. The mode of delivery for a breech fetus is reviewed, including primary cesarean delivery, vaginal breech delivery, and external cephalic version. Earlier studies have demonstrated an association between vaginal breech delivery and poor neonatal outcomes. While more recent data have reaffirmed that vaginal breech can be approached with a well-trained team, the earlier data and changing training patterns have prompted cesarean delivery to be the typical mode of delivery of singleton breech fetuses. External cephalic can be offered to appropriate candidates to decrease the cesarean delivery rate due to fetal malpresentation.

  • Chapter 12 - Breech Presentation

  • from Part II - INTRAPARTUM AND POSTPARTUM
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book:
    Operative Obstetrics
    Published online:
    07 May 2010
    Print publication:
    04 August 2008, pp 297-321

  • Summary

    This chapter reviews the fundamentals of the techniques for breech delivery and the evaluative process required for appropriate management. Also reviewed are external cephalic version (ECV) and internal podalic version (IPV) and the special needs of the premature breech fetus at delivery. These concepts and approaches are applicable in all breech presentations, independent of the route of delivery. Techniques for delivering the breech fetus are assisted breech delivery, delivering the aftercoming head, and breech extraction. Piper forceps (or alternatively, Simpson or Keilland forceps) can be used for delivering the aftercoming head at the clinician's discretion. The risk that the breech fetus might become acidotic during labor and delivery is marginally greater than for its cephalic counterpart. Once a breech presentation has been diagnosed, the patient and her family can be counseled and instructed about the potential problems that might be encountered.