SUMMARY: ACOG has released guidance that addresses the trend in the United States to deliver term singleton fetuses in breech presentation. If the presentation of a breech presentation is confirmed at term, a . the American College of Obstetricians and Gynecologists (ACOG) and the. The incidence of breech presentation decreases from about 20% at 28 weeks of asphyxia or trauma.1,2 Caesarean section for breech presentation has been.

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Obstetrician-gynecologists and other obstetric care providers should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, presntation a planned vaginal delivery of a vertex-presenting fetus, and has no contraindications.

If Your Baby Is Breech – ACOG

A condition in which the placenta has begun to separate from the inner wall of the uterus before the baby is born. This information is designed as an bdeech resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary.

The American College of Obstetricians and Gynecologists makes the following recommendations: Women’s Health Care Physicians. A planned vaginal birth of a single breech fetus may be considered in some situations. If there is pressure put on the cord or it becomes pinched, it can decrease the flow of blood and oxygen through the cord to the baby. Obstetrician—gynecologists and other obstetric care providers should offer external cephalic version as an alternative to planned cesarean for a woman who has a term singleton breech fetus, desires a planned vaginal delivery of a vertex-presenting fetus, and has no presehtation 9.

The same researchers preesntation published three follow-up studies breehc maternal outcomes at 3 months postpartum, as well as outcomes for mothers and children 2 years after the births 4—6.

A condition in which the membranes that hold the amniotic fluid rupture before labor. The frequency brerch adverse events was not significantly different between groups receiving and not receiving regional anesthesia for external cephalic version The combined neonatal mortality rate decreased from 0.


In the last weeks of pregnancy, fetuses usually move so that their heads are positioned to come out of the vagina first during birth. This Committee Opinion is updated as highlighted to reflect a limited, focused change in the evidence regarding external cephalic version for breech presentation at term.

Use of this Web site constitutes acceptance of our Terms of Use. A systematic review and meta-analysis of six randomized controlled trials found that using epidural or spinal anesthesia significantly increased the success rate of external cephalic version from More than one half of attempts breevh ECV succeed. Teaching vaginal breech delivery and external cephalic version.

Planned vaginal delivery of a term singleton breech fetus may be reasonable under hospital-specific protocol guidelines for eligibility and labor management. The health care professional performs ECV by placing his or her hands on your abdomen.

Women’s Health Care Physicians

This information should not be considered as inclusive of all proper treatments or presentaion of care or as a statement of the standard of care.

American College of Obstetricians and Gynecologists.

An ultrasound exam or pelvic exam may be used to confirm it. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations.

Planned caesarean section for term breech delivery. At 3 months postpartum, the risk of urinary incontinence was lower for women in the planned cesarean delivery group; however, there was no difference at 2 years. Oxytocin induction or augmentation was not offered, and strict criteria were established for normal labor progress.

Only 6 of the 16 infants who died in the neonatal period were from centers participating in the follow-up to 2 years one in breecy planned cesarean delivery group, five in the planned vaginal delivery groupand most of the children with serious neonatal morbidity after birth survived and developed normally.

Cesarean delivery will be the preferred mode of delivery for most physicians because of the diminishing expertise in vaginal breech delivery. Another report noted similar outcomes in women with planned vaginal delivery Offering external cephalic version provides an opportunity to potentially reduce cesarean delivery for these aacog 10, Occasionally fetuses with certain birth defects will not turn into the head-down position before birth.


Today, most fetuses that are breech are born by planned cesarean delivery. Recommendations The American College of Obstetricians and Gynecologists makes the following recommendations: A breech presentation occurs when the fetus’s buttocks, feet, or both are in place to come out first during birth.

However, some fetuses who are successfully turned with ECV move back into a breech presentation. Inresearchers conducted a large, international multicenter randomized clinical trial comparing a policy of planned cesarean delivery with planned vaginal delivery Term Breech Trial 3.

Obstetricians should offer and perform external cephalic version whenever possible. Firm pressure is applied to the abdomen so that the fetus rolls into a head-down position. If this happens, ECV may be tried again. Even in academic medical centers where faculty support for teaching vaginal breech delivery to residents remains high, there may greech insufficient volume of vaginal breech deliveries to adequately teach this procedure 2.

Most children, of 1, At 2 years postpartum, the majority of women External cephalic version should be attempted only in settings in which cesarean delivery services are readily available 9.

ACOG Committee Opinion No. Mode of term singleton breech delivery.

If presentaiton have further questions, contact your obstetrician—gynecologist. The follow-up study was underpowered to show a clinically important benefit from cesarean delivery if this were true. In addition, the protocol presented presetation one report required documentation of fetal head flexion and adequate amniotic fluid volume, defined as a 3-cm vertical pocket Planned caesarean section decreases the risk of adverse perinatal outcome due to both labour and delivery complications in the Term Breech Trial.

Singleton vaginal breech delivery at term: