Breech Birth

Introduction

• Description: Breech birth is the presentation of the fetal buttocks (frank breech; 50%–70%), one foot, or both feet at the cervix (complete breech with hips flexed, 5%–10%; incomplete breech with the hips extended, 10%–40%) at the time of labor.

• Prevalence: The rate of breech deliveries decreases with advancing gestational age from 22%–25% of births less than 28 weeks, to 7%–15% of births at 32 weeks, to 3%–4% of births at term.

• Predominant Age: Reproductive age.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Prematurity, fetal or maternal anomalies (eg, fetal hydrocephalus, maternal uterine anomalies), multiple gestation.

• Risk Factors: Prematurity, fetal or uterine anomalies, multiple pregnancies, prior breech pregnancy.

Signs and Symptoms

• Fetal head located outside the pelvis on abdominal palpation (Leopold maneuvers)

• Fetal heart heard high in the uterus

• Buttock, one foot, or both feet palpable on cervical examination

Diagnostic Approach