What is Breech Presentation?
Breech presentation is a condition in which a fetus is positioned to be delivered buttocks or feet first instead of the usual head-first position. This occurs in approximately 3-4% of full-term births. Understanding this condition is essential for nurses in providing appropriate care and support to both the mother and the fetus.
Types of Breech Presentation
There are three main types of breech presentations: Frank breech: The fetus's buttocks are aimed at the birth canal with legs sticking straight up in front of the body and the feet near the head.
Complete breech: The fetus sits cross-legged, with both buttocks and feet positioned to come out first.
Footling breech: One or both feet are positioned to come out before the buttocks.
Causes and Risk Factors
There are several potential causes and risk factors for breech presentation, including: Premature birth
Multiple pregnancies (twins or more)
Excessive or insufficient amniotic fluid
Uterine abnormalities or fibroids
Placenta previa
Previous pregnancies
Diagnosis
Breech presentation can be diagnosed through a combination of physical examination and imaging techniques. A nurse or healthcare provider may palpate the abdomen to determine the fetal position.
Ultrasound is commonly used to confirm the diagnosis and assess the specific type of breech presentation.
Management and Nursing Interventions
Management of breech presentation depends on several factors, including the type of breech, the gestational age of the fetus, and the mother's health. Nursing interventions may include:External Cephalic Version (ECV)
ECV is a procedure in which a healthcare provider attempts to turn the fetus to a head-down position by applying pressure to the mother's abdomen. This procedure is typically performed between 36 and 38 weeks of gestation. Nurses play a critical role in preparing the mother for the procedure, monitoring the fetus, and providing emotional support.
Planned Cesarean Section
If ECV is unsuccessful or not recommended, a planned
Cesarean section may be scheduled. Nurses assist in preoperative preparations, provide postoperative care, and educate the mother about recovery and newborn care.
Vaginal Breech Delivery
In select cases, a vaginal breech delivery may be considered. This decision is based on the type of breech, the mother's and fetus's health, and the healthcare provider's experience. Nurses are instrumental in monitoring labor progress, providing pain management, and preparing for potential complications.
Complications
Breech presentation can lead to several complications during delivery, including: Umbilical cord prolapse
Birth trauma
Fetal distress
Increased risk of cesarean delivery
It is essential for nurses to be vigilant and prepared to manage these complications promptly.
Postpartum Care
Postpartum care for mothers who have experienced a breech presentation includes monitoring for signs of infection, managing pain, and providing education on infant care. Nurses also support mothers emotionally, particularly if the delivery did not go as planned.Conclusion
Breech presentation poses unique challenges in obstetric nursing. Nurses must be knowledgeable about the different types of breech presentations, diagnostic methods, and various management strategies. They play a vital role in providing comprehensive care, ensuring the safety of both the mother and fetus, and supporting the family throughout the childbirth process.
