If Baby Is Breech, Technology Might Help

Ultrasound can detect infants turned in the womb, allowing time for decisions

By Kathleen Doheny
HealthDay Reporter

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FRIDAY, Aug. 7 (HealthDay News) -- Babies poised to enter the world feet first can pose serious complications for themselves and their moms.

Among single-baby pregnancies, just 3 percent to 5 percent are known as "breech presentations," with the baby's bottom, rather than head, positioned closest to the birth canal.

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But though the numbers are small, experts say the risks can be big. Because of this, knowing about a breech presentation ahead of time can help the parents-to-be and their doctor decide what to do -- whether to try to rotate the baby in the womb or prepare for a Cesarean delivery.

"The trend is not to deliver breech vaginally," said Dr. Joshua Copel, a professor of obstetrics, gynecology and reproductive sciences at the Yale University School of Medicine. "Most breech [babies] get delivered by C-section."

With breech presentation, vaginal birth can be far more difficult. According to the American College of Obstetricians and Gynecologists, it can be difficult to guide the baby's head out of the mother's body last because the baby's body might not have stretched the cervix sufficiently. And a prolapsed cord -- when the umbilical cord slips into the birth canal before the baby, stopping the flow of blood to the baby -- is another increased risk in vaginal deliveries of breech babies.

The standard way to detect breech -- by feeling a woman's abdomen -- isn't foolproof. A BMJ study, in fact, reported that 30 percent of breech presentations were missed when this method was used. In some cases, that has prompted the addition of an ultrasound examination if a breech presentation is suspected.

"If I am uncertain about a baby's position by 33 or 34 weeks, I recommend an ultrasound," said Susan Moray, a certified professional midwife in Portland, Ore., and a spokeswoman for the Midwives Alliance of North America. "I think it's used more than in the past."

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