BREECH DELIVERY
,FIRST STAGE OF LABOUR: VAGINAL
BREECH AT TERM
involves a longitudinal lie of the fetus,
with the buttocks in the lower pole of the maternal uterus.
The presenting diameter is the bitrochanteric (10 cm) and the
denominator is the sacrum.
As pregnancy progresses, the incidence of breech presentation
reduces: being around 15% at 28–32 weeks to around 3–4% by
term as a result of spontaneous version (MIDIRS 2008b).
It is worth considering, therefore, that a breech presentation at
term is not an abnormality, it is just unusual and so a normal
labour and spontaneous vaginal birth should not be excluded.
Although in Western childbirth culture a breech birth has the
status of an emergency, in many parts of the world a vagina
breech birth is part of normal practice
,TYPES OF BREECH PRESENTATION
AND POSITION
Breech with extended legs (frank breech)
The breech presents with the hips flexed and legs extended on the
abdomen
This type is particularly common in primigravidae whose efficient
uterine muscle tone inhibits flexion of the legs and free turning of
the mobile fetus.
Consequently, this type of breech constitutes
70% of all breech presentations.
, Complete breech
The fetal attitude is one of complete flexion with hips and knees
both flexed and the feet tucked in beside the buttocks.
Footling breech
One or both feet present due to the fact that neither hip is fully
flexed
The feet are lower than the buttocks, distinguishing it from the
complete breech.
This type of breech is rare.
Knee presentation
This breech type is particularly rare and presents with one or both
hips extended, with the knees flexed
,FIRST STAGE OF LABOUR: VAGINAL
BREECH AT TERM
involves a longitudinal lie of the fetus,
with the buttocks in the lower pole of the maternal uterus.
The presenting diameter is the bitrochanteric (10 cm) and the
denominator is the sacrum.
As pregnancy progresses, the incidence of breech presentation
reduces: being around 15% at 28–32 weeks to around 3–4% by
term as a result of spontaneous version (MIDIRS 2008b).
It is worth considering, therefore, that a breech presentation at
term is not an abnormality, it is just unusual and so a normal
labour and spontaneous vaginal birth should not be excluded.
Although in Western childbirth culture a breech birth has the
status of an emergency, in many parts of the world a vagina
breech birth is part of normal practice
,TYPES OF BREECH PRESENTATION
AND POSITION
Breech with extended legs (frank breech)
The breech presents with the hips flexed and legs extended on the
abdomen
This type is particularly common in primigravidae whose efficient
uterine muscle tone inhibits flexion of the legs and free turning of
the mobile fetus.
Consequently, this type of breech constitutes
70% of all breech presentations.
, Complete breech
The fetal attitude is one of complete flexion with hips and knees
both flexed and the feet tucked in beside the buttocks.
Footling breech
One or both feet present due to the fact that neither hip is fully
flexed
The feet are lower than the buttocks, distinguishing it from the
complete breech.
This type of breech is rare.
Knee presentation
This breech type is particularly rare and presents with one or both
hips extended, with the knees flexed
