1.1. Definition. General considerations
Breech presentation is a fetal malpresentation, where the buttocks or lower extremities of the fetus present in the pelvic inlet and appear first when moving along through the birth canal. This creates many difficulties in labor and leads to numerous complications, since the diameters of the pelvic pole are much smaller than the diameters of the fetal head.
Currently, delivery in breech presentation is not considered pathological. Still, among children born in breech presentation general morbidity is somewhat higher, long-term unfavorable consequences of birth trauma (paresis, mental development retardation, epilepsy) are more common. On the maternal side, there can occur such complications as birth canal laceration, abnormal labor, postpartum infectious disease.
Unfavorable perinatal outcomes are due to the fact that the pelvic pole, the smaller part of fetus, is the first to pass through the birth canal and be delivered, followed by the larger head, delivering which can cause difficulties.
Perinatal mortality and morbidity in fetuses born in breech presentation is higher due to prematurity, congenial development anomalies, birth trauma and asphyxia.
Providing prenatal and intranatal care in breech presentations requires profound knowledge and high professional skills to provide qualified assistance to the mother and fetus. Over the last 30 years there has been a worldwide trend to deliver cases of breech presentation by cesarean section.
Prevalence ofbreech presentations for the last several decades remains constant, at about 3-4% on the average. This is primarily due to multiple causes of breech presentation, which are most often impossible to eliminate.