Detecting breech births

By HSC Staff Writer • Published: December 7th, 2006
Category: Health in a Heartbeat

Having a baby is less risky than it used to be.

But complications still happen.

For example, babies in the womb don’t always move into the head-down position needed for easy delivery.

Three to four percent of full-term pregnancies involve breech presentation, where the baby approaches the birth canal bottom or feet first. Breech presentation is more common among premature births.

These situations may require Caesarean delivery. But if they’re detected before labor begins, an obstetrician can sometimes reposition the baby.

For decades, the standard exam for breech presentation involved palpating the mother’s abdomen. But the advent of ultrasound technology enabled doctors to see babies in the womb.

A study published recently in the British Medical Journal suggests manual examinations may be too imprecise to use exclusively.

Researchers arranged for more than sixteen-hundred pregnant women to undergo a standard exam, then a separate ultrasound evaluation.

Ultrasound revealed one-hundred-thirty breech presentations. But manual exams found only ninety-one.

Furthermore, about five percent of babies in normal head-first presentation were misidentified as being in an abnormal presentation.

Doctors were more likely to miss breech presentation in thin or heavy patients. Obese women fared the worst, with more than half the breeches missed.

The study didn’t try to determine how well individual doctors performed. So the results shouldn’t be considered an indicator of every obstetrician’s skill.

But the lesson for patients is clear. When it comes to detecting breech births, don’t be afraid to ask for a second opinion… from ultrasound.