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BREECH DELIVERY
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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 prog...

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  • October 21, 2024
  • 55
  • 2024/2025
  • Class notes
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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

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