8.3.4 Risks of breech presentation
Refer all cases of breech presentation to the nearest higher-level health facility.
Regardless of the type of breech presentation, there are significant associated risks to the baby. They include:
- The fetal head gets stuck (arrested) before delivery
- Labour becomes obstructed when the fetus is disproportionately large for the size of the maternal pelvis
- Cord prolapse may occur, i.e. the umbilical cord is pushed out ahead of the baby and may get compressed against the wall of the cervix or vagina
- Premature separation of the placenta (placental abruption)
- Birth injury to the baby, e.g. fracture of the arms or legs, nerve damage, trauma to the internal organs, spinal cord damage, etc.
A breech birth may also result in trauma to the mother’s birth canal or external genitalia through being overstretched by the poorly fitting fetal parts.
Cord prolapse in a normal (vertex) presentation was illustrated in Study Session 17 of the Antenatal Care Module, and placental abruption was covered in Study Session 21.
What will be the effect on the baby if it gets stuck, the labour is obstructed, the cord prolapses, or placental abruption occurs?
The result will be hypoxia, i.e. it will be deprived of oxygen, and may suffer permanent brain damage or die.
You learned about the causes and consequences of hypoxia in the Antenatal Care Module.