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Breech presentation

Last reviewed: 12 Oct 2024
Last updated: 21 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • buttocks or feet as the presenting part
  • fetal head under costal margin
  • fetal heartbeat above the maternal umbilicus
Full details

Other diagnostic factors

  • subcostal tenderness
  • pelvic or bladder pain
Full details

Risk factors

  • premature fetus
  • small for gestational age fetus
  • nulliparity
  • fetal congenital anomalies
  • previous breech delivery
  • uterine abnormalities
  • abnormal amniotic fluid volume
  • placental abnormalities
  • female fetus
Full details

Diagnostic tests

1st tests to order

  • transabdominal/transvaginal ultrasound
Full details

Treatment algorithm

INITIAL

<37 weeks' gestation and in labor

≥37 weeks' gestation not in labor

ACUTE

≥37 weeks' gestation in labor: no imminent delivery

≥37 weeks' gestation in labor: imminent delivery

Contributors

Authors

Natasha Nassar, PhD

Associate Professor

Menzies Centre for Health Policy

Sydney School of Public Health

University of Sydney

Sydney

Australia

Disclosures

NN has received salary support from Australian National Health and a Medical Research Council Career Development Fellowship; she is an author of a number of references cited in this topic.

Christine L. Roberts, MBBS, FAFPHM, DrPH

Research Director

Clinical and Population Health Division

Perinatal Medicine Group

Kolling Institute of Medical Research

University of Sydney

Sydney

Australia

Disclosures

CLR declares that she has no competing interests.

Jonathan Morris, MBChB, FRANZCOG, PhD

Professor of Obstetrics and Gynaecology and Head of Department

Perinatal Medicine Group

Kolling Institute of Medical Research

University of Sydney

Sydney

Australia

Disclosures

JM declares that he has no competing interests.

Peer reviewers

John W. Bachman, MD

Consultant in Family Medicine

Department of Family Medicine

Mayo Clinic

Rochester

MN

Disclosures

JWB declares that he has no competing interests.

Rhona Hughes, MBChB

Lead Obstetrician

Lothian Simpson Centre for Reproductive Health

The Royal Infirmary

Edinburgh

Scotland

Disclosures

RH declares that she has no competing interests.

Brian Peat, MD

Director of Obstetrics

Women's and Children's Hospital

North Adelaide

South Australia

Australia

Disclosures

BP declares that he has no competing interests.

Lelia Duley, MBChB

Professor of Obstetric Epidemiology

University of Leeds

Bradford Institute of Health Research

Temple Bank House

Bradford Royal Infirmary

Bradford

UK

Disclosures

LD declares that she has no competing interests.

Justus Hofmeyr, MD

Head of the Department of Obstetrics and Gynaecology

East London Private Hospital

East London

South Africa

Disclosures

JH is an author of a number of references cited in this topic.

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