breech birth [ME, brech + burth] , a delivery that is bottom first rather than head first, occurring in about 2% of singleton deliveries at term. There are three breech presentations: frank breech (both feet near head), complete breech (legs are crossed and feet are not near the head), and incomplete or footling breech (one or both feet are extended). Breech presentation is more common in a multiple pregnancy or in women with polyhydramnios, uterine anomalies, or uterine fibroid tumors. Fetal conditions associated with breech birth include hydrocephalus and anencephaly. The risks of vaginal delivery include entrapment of the “aftercoming head” and umbilical cord prolapse. Facilitating delivery of the aftercoming fetal head may be done using Piper forceps. Because of these serious risks, many prefer cesarean section rather than a trial of breech delivery. Also because of these risks, manual version to a cephalic presentation (external cephalic version, ECV) may be considered, generally between 36 and 38 weeks gestational age, when there is a lesser incidence of reversion to the breech. See also assisted breech, breech presentation, complete breech, footling breech, frank breech, version and extraction.
