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Breech Presentation

Overview

Breech presentation is defined as a fetus in a longitudinal lie with the buttocks or feet closest to the cervix. This occurs in 3-4% of all deliveries. The percentage of breech deliveries decreases with advancing gestational age from 22-25% of births prior to 28 weeks’ gestation to 7-15% of births at 32 weeks’ gestation to 3-4% of births at term.

Predisposing factors for breech presentation include prematurity, uterine malformations or fibroids, polyhydramnios, placenta previa, fetal abnormalities (eg, CNS malformations, neck masses, aneuploidy), and multiple gestations. Fetal abnormalities are observed in 17% of preterm breech deliveries and in 9% of term breech deliveries.

Perinatal mortality is increased 2- to 4-fold with breech presentation, regardless of the mode of delivery. Deaths are most often associated with malformations, prematurity, and intrauterine fetal demise.

Types of breeches

See the list below:

Frank breech (50-70%) – Hips flexed, knees extended (pike position)

Complete breech (5-10%) – Hips flexed, knees flexed (cannonball position)

Footling or incomplete (10-30%) – One or both hips extended, foot presenting

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