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Undetected breech presentation: impact on external version and cesarean rates
1Department of Obstetrics and Gynecology, Kaiser Permanente Medical Center, Riverside, California 92505, USA.
American Journal of Perinatology
|June 27, 1998
Summary
Many breech presentations go undetected, impacting external cephalic version success. Increased third-trimester screening for breech presentation may reduce cesarean deliveries.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Undetected breech presentation complicates labor and delivery planning.
- External cephalic version (ECV) is a procedure to turn a fetus from breech to cephalic presentation before labor.
- Cesarean delivery is often required for term breech presentations.
Purpose of the Study:
- To assess the frequency of undetected breech presentations impacting an ECV program.
- To evaluate the association between undetected breech presentation and cesarean delivery rates.
Main Methods:
- Retrospective analysis of ECV attempts over one year.
- Analysis of cesarean operations for breech presentation during the same period.
- Exclusion of twin gestations and premature births.
Main Results:
- 21% of term breech presentations were undetected before labor onset.
- An additional 15% of term breech presentations were detected after 38 weeks' gestation.
- Undetected breech presentations likely influenced ECV program outcomes and cesarean rates.
Conclusions:
- A significant proportion of term breech presentations remain undetected, potentially hindering ECV programs.
- Enhanced third-trimester screening for breech presentation is recommended.
- Improved detection rates could decrease the incidence of cesarean deliveries for breech presentation.