Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about Breach presentation.

And you can find written notes on this topic at zero to finals.com slash breach or in the antinatal care section of the zero to finals, obstetrics and

gynecology book.

So let's get straight into it.

A breach presentation refers to when the presenting part of the fetus, the lowest part,

is the legs in the bottom.

This is opposed to cafalic presentation where the head is the presenting part.

Breach presentation occurs in less than 5% of pregnancies by the time they reach 37 weeks gestation.

Let's talk about the types of breach presentation. There are four main types to remember.

Complete breach, which is where the legs are fully flexed at the knees and the hips,

as though the baby is doing a cannonball into a swimming pool.

Incomplete breach, which is where one leg is flexed at the hip and knee as normal,

and the other leg is flexed at the hip and knee as normal and the other leg is flexed at the hip

and extended at the knee so that the baby's foot is up by its face. Extended breach which is also known

as Frank Breach where both legs are flexed at the hip and extended at the knee with both feet up by the baby's face

and footling breach which is where a foot is presenting through the cervix with the leg extended

next let's talk about management babies that are breach before 36 weeks often turn spontaneously so no

intervention is required. A procedure called external catholic version or ECV can be

used at term at 37 weeks gestation to attempt to turn the fetus if they're in a

breach position.

Where external catholic version fails, women are given a choice between a vaginal delivery in the breach presentation or an elective caesarean section.

Viginal delivery needs to involve experienced midwives and obstetricians, with access to emergency

...