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William Campbell
William Campbell

Breech Closer ##TOP##

If you planned a vaginal delivery, a breech baby could change these plans. When your baby is breech, a vaginal delivery can be complicated and dangerous. Your healthcare provider may feel comfortable attempting a vaginal breech delivery, but in most cases, they will recommend a Cesarean birth (C-section).

breech closer


If your baby presents in a breech position after 36 weeks of pregnancy, your birthing plan will likely change. It's usually unsafe for a breech baby to be born vaginally due to risks of injury. In most cases, a planned C-section is the safest way to deliver your baby. Some healthcare providers may be comfortable with a vaginal breech birth. In some cases, turning your baby to a head-down position while they are still inside your uterus is an option. Your baby is then born head first.

You may be able to tell if your baby is breech, especially if you have had past pregnancies where your baby was head-first. The places where you feel lumps and kicks might indicate that your baby is breech. Let your healthcare provider know where you feel movement. They will feel your belly or do an ultrasound to confirm that your baby is breech.

If your baby is breech, your healthcare provider may consider turning your baby so that you can have a vaginal delivery. In some cases, trying to turn your baby may not be safe or the risks outweigh the benefits.

The most common method used to turn a breech baby is called external cephalic version (ECV). It's performed by your healthcare provider around 37 weeks of pregnancy. This procedure is performed in the hospital just in case an emergency occurs. It involves placing hands on your abdomen and applying firm pressure to turn your baby to a head-down position while your baby is still in your uterus. It is about 65% effective and carries some risks.

Most babies will flip to a head-down position before they reach full term (37 weeks). If your baby is still in a breech position at this time, your healthcare provider will determine if you can deliver vaginally or if you will need a C-section.

Most of the time, a C-section is the safest way to deliver a breech baby. Your risks of developing complications are much higher if you try to deliver a breech baby through the vagina. However, some healthcare providers may feel comfortable performing a vaginal breech birth.

Having a breech baby can be unexpected and change the vision you had for childbirth. Talk to your healthcare provider about what to expect during a breech delivery. They can help you understand the risks and benefits of a breech birth so that you and your baby are kept safe.

Brusalis CM, Price CT, Sankar WN. Incidence of acetabular dysplasia in breech infants following initially normal ultrasound: the effect of variable diagnostic criteria. J Child Orthop. 2017;11(4):272-276. doi:10.1302/1863-2548.11.160261

Before birth, most babies are in a head-down position in the mother's uterus. That's why most babies are born headfirst. Sometimes the part of the baby that is head down is not the head, but the buttocks or the feet. When a baby is in that position before birth, it's called a breech birth or breech baby. Many babies are breech early in pregnancy, but most of them turn to the headfirst position near the end of the pregnancy. Babies that are born early are more likely to be breech. If more than one baby is in the uterus at one time, one or more of the babies may be breech. Abnormal levels of amniotic fluid around the baby may result in a breech birth. As you get closer to your due date, your doctor will be able to tell (by physical exam, ultrasound, or both) if your baby is breech.

Some breech babies may be safely delivered from the vagina. However, more complications can occur if the baby is breech. A baby who is breech may be very small, or it may have birth defects. Breech babies may also have accidents during delivery that can damage the umbilical cord or cause asphyxia, or even cause death of the mother or baby.

Although breech babies can be delivered vaginally, it's generally safer and easier to deliver babies head first from the vagina. So, many times doctors deliver breech babies by cesarean delivery (c-section). Risks are involved with cesarean delivery, too, such as bleeding, infection and longer hospital stays for both the mother and her baby.

It's very important to see your doctor regularly when you're pregnant. Your doctor can tell if your baby is breech and help plan what to do. Some doctors will plan to deliver the baby by cesarean section. Others may give their patients exercises to do at home that may help turn the baby to the head-first position. Some doctors try to turn the baby in the mother's uterus using a procedure called external cephalic version. If this procedure is successful and the baby stays head down, a normal vaginal delivery is more likely.

External cephalic version is a way to try to turn a baby from breech position to vertex (head-down) position while it's still in the mother's uterus. In other words, external cephalic version means turning the baby from outside of the abdomen so that it's in the head-down position. Your doctor will use his or her hands on the outside of your abdomen (tummy) to try to turn the baby (see the pictures).

External cephalic version is usually done in the hospital. Before the procedure, you will have an ultrasound to confirm that the baby is breech. Your doctor will also do a nonstress test to make sure that the baby's heart rate is normal. A tube of blood will be drawn, and an anesthesiologist will be notified, just in case you need to have an emergency cesarean delivery. You'll be given medicine through a vein in your arm to relax your uterus. This medicine is very safe, with no risk to your baby. While you're lying down, the doctor will place his or her hands on the outside of your abdomen. After locating the baby's head, the doctor will gently try to turn the baby to the vertex position.

The average success rate is about 65 percent. Even if the procedure works at first, there's still a chance that the baby will turn back around to the breech position. This also depends on the factors listed above.

It is not always possible to turn your baby from being breech. Some breech babies can be safely delivered through the vagina, but usually doctors deliver them by C-section. Risks involved with a C-section include bleeding and infection. There also can be a longer hospital stay for both the mother and her baby.

Introduction: Breech presentation is linked to abnormal pregnancy outcomes. However, the causality of this association is unknown. We aimed to investigate predictors of term breech presentation and pregnancy outcomes of breech presentation.

Results: Breech presentation was independently associated with older maternal age, medical history (primiparity, stillbirth, spontaneous abortion, hormone treatment, and assisted reproduction), maternal morbidities (hypertension and oligohydramnios), and the fetal factors (female sex, younger gestational age at delivery, developmental abnormalities, small for gestational age, and birthweight). An adverse delivery outcome was 11.7 times (95% confidence interval 11.3-12.0) and an adverse fetal outcome was 1.39 times (95% confidence interval 1.33-1.45) more frequent in pregnancies with breech presentation compared with cephalic presentation. Further adjustment for predictors of breech presentation had no major effect on the delivery outcome, but it reduced the risk of adverse fetal outcome (odds ratio 1.18, 95% confidence interval 1.14-1.24).

Conclusions: Breech presentation is a marker of pathological pregnancy and is independently associated with an increased risk of gestational complications. Closer surveillance and appropriate management of pregnancies with breech presentation is warranted to prevent adverse perinatal outcomes.

External cephalic version (ECV) is an attempt to turn the fetus so that he or she is head down. ECV can improve your chance of having a vaginal birth. If the fetus is breech and your pregnancy is greater than 36 weeks your health care professional may suggest ECV.

More than one half of attempts at ECV succeed. However, some fetuses who are successfully turned with ECV move back into a breech presentation. If this happens, ECV may be tried again. ECV tends to be harder to do as the time for birth gets closer. As the fetus grows bigger, there is less room for him or her to move.

Most fetuses that are breech are born by planned cesarean delivery. A planned vaginal birth of a single breech fetus may be considered in some situations. Both vaginal birth and cesarean birth carry certain risks when a fetus is breech. However, the risk of complications is higher with a planned vaginal delivery than with a planned cesarean delivery.

If you are thinking about having a vaginal birth and your fetus is breech, your health care professional will review the risks and benefits of vaginal birth and cesarean birth in detail. You usually need to meet certain guidelines specific to your hospital. The experience of your health care professional in delivering breech babies vaginally also is an important factor.

She wrote: "As I lay awake late at night, researching, I've learned that you actually can deliver a breech baby and I feel fortunate that my doctor Paul Crane is one of the few doctors that still does this. They just don't even teach it anymore."

1. Adjective In some species, such as people, a breech birth is uncommon and fairly risky. 2. Noun, singular or mass The skirt should be even with the edge of the breech or pushed slightly into it.

If your baby is lying bottom or feet first, they are in the breech position. If they're still breech at around 36 weeks' gestation, the obstetrician and midwife will discuss your options for a safe delivery.

If your baby is in a breech position at 36 weeks, you'll usually be offered an external cephalic version (ECV). This is when a healthcare professional, such as an obstetrician, tries to turn the baby into a head-down position by applying pressure on your abdomen. It's a safe procedure, although it can be a bit uncomfortable. Around 50% of breech babies can be turned using ECV, allowing a vaginal birth. 041b061a72


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