Handling when the fetus is breech

The article was professionally consulted by a Doctor of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

In cases that are determined to be breech pregnancy, doctors often appoint a elective cesarean section because they want to be safe for both mother and baby, that is, not all cases require caesarean section. However, in case the breech position is sufficient and the breech position is lacking, the pregnant woman may be assigned a vaginal delivery, but depending on the mother's health and the fetal movement during labor, the doctor will There are suitable solutions for pregnant women.

The position of the fetus in the womb is very important
During pregnancy, the fetus will often move and change its position in the mother's belly. However, before the due date, most fetuses turn their head down into the lower part of the uterus and the head rests in the mother's pelvis. But about 4% of babies rotate their buttocks (or legs) downwards. When the fetus is in such a position before birth, it is called the breech or breech position.
The breech pregnancy includes 3 types:
Full breech pregnancy: The baby's buttocks are facing down the birth canal, the knees are bent as if sitting cross-legged. Incomplete breech position - breech pattern: Baby's bottom is pointing down the birth canal, legs extended straight in front of baby, feet very close together. Incomplete breech position - foot pattern: This means that one or both of your baby's feet are pointing down the birth canal. As for why the fetus is in the breech position, it is difficult to say exactly, but there are some complications that can greatly affect the position of the fetus such as:
breech pregnancy is more likely to occur in pregnant women having multiples, premature birth, or a baby with a placenta problem. Amniotic fluid in the uterus can also be the cause of this phenomenon (too little or too much amniotic fluid in the uterus). An irregularly shaped uterus or fibroids can both make it difficult for the baby to turn its head downwards in the last months.

Is the breech pregnancy dangerous not a problem that many pregnant women wonder about. In the opinion of doctors, breech delivery is considered dangerous, because dangerous complications can occur. Specifically:
It will become very difficult to get the baby out of the womb. In the worst case, the fetus is deprived of oxygen. This is because the water breaks before labor and the placenta will follow the amniotic fluid out. The baby's head is the largest and hardest part and is born last, so there is a risk that the hind end can cause fetal death or trauma. In the case of incomplete breech - leg style, pregnant women are at risk of uterine prolapse, which can put pressure on the belly button, thereby limiting blood flow to the baby. If the baby is born vaginally, there is a very high risk of having a leg deformity. In the case of incomplete breech - breech and full breech positions are more likely to be able to have a safe vaginal delivery. However, to minimize complications you need help and advice from doctors and medical staff with good skills. The breech baby is not dangerous but makes it difficult for pregnant women to give birth.

In cases where the breech pregnancy is confirmed, the doctor will usually appoint the pregnant woman to have a selective cesarean section because to be safe for both mother and child, that is, not all cases require caesarean section.
In case the breech position is sufficient and the buttocks are lacking, the pregnant woman may be assigned a normal delivery. This depends on the mother's health, the baby's rotation during labor, the doctor will have a suitable solution for the mother. Specifically, breech pregnancy can be indicated for normal delivery when:
The case is that the fetus is fully breech or lacks the breech shape. The mother's pelvis is wide, the cervix is ​​dilated. Fetal head bows well. The fetus weighs less than or equal to 3,200g. In the case of accompanying abnormalities as follows, the doctor is forced to perform a cesarean section:
In case the fetus is breech with lack of leg type. The labor process is prolonged. The mother's pelvis is narrow. The fetal head bow is not good. Old incision on the uterus. First time giving birth and fetal weight greater than 3,200g. So in the case that a normal delivery is not possible but the doctor appoints a cesarean section, at what week should the breech pregnancy be operated on? Accordingly, the surgery at how many weeks will be based on the periodical antenatal check-up of each pregnant woman. The most important thing for pregnant women is to regularly examine and monitor the fetus in the last weeks of pregnancy to get an accurate diagnosis.