UNCONTROLLED WHEN PRINTED
Quick Chart
Introduction

Breech presentation means the baby is lying longitudinally with its bottom and/or feet presenting first to the lower part of the mother’s uterus. (RANZCOG, 2016).

Breech occurs in 3-4% of term deliveries and is more common in preterm.

Clinical Presentation

Presentation of any part of the baby other than the head.

  • Frank breech
  • Complete breech
  • Footling breech
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Nulliparous women
  • Previous Breech presentation
  • Pre-term delivery
  • Multiple pregnancies
  • Placenta praevia
  • Malformation of uterus or foetus
  • Uterine and congenital abnormalities
Management
Primary Care
  • Delivery should NOT be attempted unless it is absolutely inevitable
  • Delivery of a footling breech should NOT be attempted in the pre-hospital setting
  • Do NOT attempt to push the baby back in or pull on baby

  • Primary Survey
  • Offer continuous support and reassurance
  • Position patient appropriately (being mindful to avoid aortocaval compression)
  • Perform maternal vital sign survey
  • Consider oxygen
Intermediate Care (EMT / Level 2)
Advanced Care (AP)
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • Significant cord compression is common
  • Liaise with obstetrics unit in the metropolitan area, recording all advice on ePCR
  • Liaise with local hospitals in country, recording all advise given on ePCR

Increased risk of short term complications:

  • Erb’s palsy (paralysis of the arm)
  • Fractures to the clavical, humerus & femur
  • Dislocations of the hips and shoulders

References
References
Key Terms & Links
Frank breech
Breech11
Complete breech
Breech12
Footling breech
Breech13
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