FOOTLING PRESENTATION PDF

Normally in the last few weeks of a pregnancy the baby will gradually reposition itself in the head down presentation in preparation for birth. Head first is the normal presentation because it is the optimal position to safely and effectively facilitate vaginal delivery. When in the head first position the crown of the baby's skull functions like a spear head which pushes into and through the birth canal. Not all babies move into the normal head-first presentation before delivery. This referred to as the "breech" position or breech presentation.

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Normally in the last few weeks of a pregnancy the baby will gradually reposition itself in the head down presentation in preparation for birth. Head first is the normal presentation because it is the optimal position to safely and effectively facilitate vaginal delivery.

When in the head first position the crown of the baby's skull functions like a spear head which pushes into and through the birth canal. Not all babies move into the normal head-first presentation before delivery.

This referred to as the "breech" position or breech presentation. Breech position is not normal and consider a pregnancy complication. The occurrence rate for breach presentation is significantly higher, however, in preterm pregnancies.

Breech presentation generally includes any presentation in which the baby's butt or feet are pointing down towards the birth canal. However, there are several different recognized subtypes of breech presentation depending on the specifics and extent of the baby's abnormal position and the positioning of the legs:. The conditions which make breech presentation more likely to occur include:. The occurrence of any of these complications during pregnancy can significantly increase the chances of breech presentation occurring.

However, breech presentation can occur in a normal pregnancy without complications. Breech presentation is something that gets diagnosed towards the very end of a full term pregnancy. A formal diagnosis of breech presentation is not made until at least the 35 th week of pregnancy because before week 35 it is perfectly normal for a baby to be positioned head-up or sideways. Repositioning is something that the baby is supposed to naturally do on their own in the final few weeks before birth.

Diagnosis of breech presentation will start in a prenatal examination occurring at or sometime after the 35 th week of gestation. The doctor will initially perform a manual abdominal exam to gently feel around and identify the apparent position of the baby's head, butt and feet. If the baby doesn't seem to be in the expected position an ultrasound will usually be done to confirm the diagnosis of breech presentation. If ultrasound imaging is not enough there are also special prenatal X-rays that can be done to give doctors a more accurate image of the baby's presentation.

There are several reasons why vaginal delivery of a breech baby is so hazardous. For starters breech presentation makes the basic mechanics of vaginal delivery much more difficult. The baby's head is the largest part of their body so it is the most difficult to push through the birth canal. In a normal, head-first delivery the crown of the baby's head sort of spears its way into and through the birth canal.

Getting the head safely through the birth canal in the reverse direction is much more difficult and potentially dangerous.

Another major reason why vaginal delivery from breech position is so hazardous is because there is a much higher risk of a delivery complication called umbilical cord prolapse. Umbilical cord prolapse is one of the most dangerous events that can occur during childbirth. It occurs when the umbilical cord the baby's lifeline to the mother drops down into the birth canal in front of the baby instead of behind like in a normal delivery.

When the cord goes first and the baby comes through the birth canal after the umbilical cord gets squeezed and compressed against the walls of the birth canal by the baby's head and body. This can severely restrict or even cut off oxygen supply to the baby and cause major brain injuries or even death from perinatal asphyxia.

Attempting a vaginal delivery when the baby is in breech position can greatly increase the risk of a birth injury. Although there is currently a major push towards doing less C-sections, breech presentation is a situation where a planned C-section is simply the most sensible option. This is particularly true for premature babies that are more fragile.

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Breech Position. Breech Position Normally in the last few weeks of a pregnancy the baby will gradually reposition itself in the head down presentation in preparation for birth. Different Types of Breech Presentation Breech presentation generally includes any presentation in which the baby's butt or feet are pointing down towards the birth canal.

However, there are several different recognized subtypes of breech presentation depending on the specifics and extent of the baby's abnormal position and the positioning of the legs: Frank Breech : the butt is still facing down toward the birth canal same as with complete breech instead of the legs being bent at the knees and tucked in the fetal position the baby's legs at straight at the knees and facing upwards so that the feet are basically in front of the face.

Footling Breech : in a footling breech presentation the baby's feet are actually pointing downward and will enter first into the birth canal ahead of the butt. Footling breech is more common in premature babies. Fooling has the second highest occurrence rate of all breech positions. Complete Breech : in complete breech presentation the butt is aimed down towards the birth canal entrance and the baby is in the traditional "fetal" position with knees bent and pulled up to the chest and feet near the butt.

Complete breech is rarest of all types of breech presentation. What Causes Breech Presentation? The conditions which make breech presentation more likely to occur include: Pregnancy with twins or multiples Mother has had prior pregnancies Maternal history of premature delivery Too much amniotic fluid polyhydramnios Placenta previa Abnormally shaped uterus or abnormal uterine growths fibroids The occurrence of any of these complications during pregnancy can significantly increase the chances of breech presentation occurring.

When and How is Breech Position Diagnosed?

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Abnormal Fetal Position and Presentation

A breech birth is when a baby is born bottom first instead of head first. Most babies in the breech position are born by a caesarean section because it is seen as safer than being born vaginally. During the first period, which lasts until the 24th gestational week, the incidence of a longitudinal lie increases, with equal proportions of breech or cephalic presentations from this lie. This period is characterized by frequent changes of presentations.

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Breech Position

Under normal circumstances, a baby is in the cephalic vertex position before delivery. However, some babies present differently before delivery. Types of abnormal fetal positions and presentations include the following. In the womb, a fetus has both a presentation and a position. In vertex presentation, the baby is positioned head-first with their occiput the part of the head close to the base of the skull entering the birth canal first. Any position other than vertex position is abnormal and can make vaginal delivery much more difficult or sometimes impossible 2.

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Breech birth

This content cannot be displayed without JavaScript. Please enable JavaScript and reload the page. Figures 6. Before labour, external version Chapter 7, Section 7. If external version is contra-indicated or unsuccessful, the breech position alone — in the absence of any other anomaly — is not, strictly speaking, a dystocic presentation, and does not automatically require a caesarean section. Deliver vaginally, if possible — even if the woman is primiparous.

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Breech Presentation

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