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Chapter 20 - Fetal Malpresentation and Breech Delivery

from Section 2 - Labor and Delivery

Published online by Cambridge University Press:  23 February 2023

By
Andrew Zakhari  and
Amira El-Messidi
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

You are covering an obstetrics clinic for your colleague who left for vacation. A 26-year-old G2P1 with a singleton pregnancy at 36+4 weeks’ gestation by first-trimester sonogram presents for a prenatal visit. First- and second-trimester fetal aneuploidy screening tests were low risk. Her primary care provider had arranged for serial obstetric sonograms in the second and third trimesters for decreased fundal height. Imaging today shows a new finding of breech presentation. The patient does not have any obstetric complaints. Your nurse mentions the patient requests an external cephalic version.

Keywords

Breech presentation, risk factorsExternal cephalic version, success, technical procedure, risks, timingInformed consentVaginal breech delivery, labor management, morbidity, contraindicationsPiper forcepsEntrapment of the aftercoming head
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 274 - 284
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

ACOG Committee Opinion No. 745: Mode of term singleton breech delivery. Obstet Gynecol. 2018;132(2):e60–e63.CrossRefGoogle Scholar
Carbillon, L, Benbara, A, Tigaizin, A, et al. Revisiting the management of term breech presentation: a proposal for overcoming some of the controversies. BMC Pregnancy Childbirth. 2020;20(1):263.CrossRefGoogle ScholarPubMed
External cephalic version: ACOG Practice Bulletin, No. 221. Obstet Gynecol. 2020;135(5):e203–e212.CrossRefGoogle Scholar
Homafar, M, Gerard, J, Turrentine, M. Vaginal delivery after external cephalic version in patients with a previous Cesarean delivery: a systematic review and meta-analysis. Obstet Gynecol. 2020;136(5):965–971.CrossRefGoogle ScholarPubMed
Impey, LWM, Murphy, DJ, Griffiths, M, et al. External cephalic version and reducing the incidence of term breech presentation. Green-Top Guideline No. 20a. BJOG 2017; 124(07):e178–e192.Google Scholar
Impey, LWM, Murphy, DJ, Griffiths, M, et al. Management of breech presentation: Green-Top Guideline No. 20b. BJOG 2017;124(07):e151–177.Google Scholar
Kotaska, A, Menticoglou, S. No. 384 – management of breech presentation at term. J Obstet Gynaecol Can. 2019;41(8):1193–1205.CrossRefGoogle ScholarPubMed
Magro-Malosso, ER, Saccone, G, Di Tommaso, M, et al. Neuraxial analgesia to increase the success rate of external cephalic version: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2016;215(3):276–286. [Correction in Am J Obstet Gynecol. 2017 Mar;216(3):315]CrossRefGoogle ScholarPubMed
Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Management of breech presentation at term. Available at https://ranzcog.edu.au/. Accessed March 6, 2021.Google Scholar
Tsakiridis, I, Mamopoulos, A, Athanasiadis, A, et al. Management of breech presentation: a comparison of four national evidence-based guidelines. Am J Perinatol. 2020;37(11):1102–1109.Google ScholarPubMed

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