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Management of pregnancy with breech presentation of the fetus
Last reviewed: 08.07.2025
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Pregnancy and childbirth with a breech presentation of the fetus should be considered pathological. Childbirth with a breech presentation of the fetus poses a certain danger both for the woman and especially for the fetus. With this presentation, perinatal mortality is 4-5 times higher compared to childbirth in the cephalic presentation. Breech presentations of the fetus are observed in 4-5% of women in labor; in premature pregnancy, the frequency of breech presentations increases.
Breech presentations of the fetus are divided into breech and foot; breech, in turn, are divided into pure breech and mixed breech. Mixed breech presentation can be complete and incomplete. Foot presentations are divided into complete, incomplete and split. Among foot presentations, incomplete are more common; knee presentations are extremely rare.
As the fetus grows, it occupies an ever-increasing volume of the uterine cavity and strives to adapt to the ovoid of the latter. The etiology of breech presentation may be associated with a deviation from this adaptive process or a violation of the fetal position in the uterus. Breech presentation of the fetus may be due to the following factors:
- changes in the lower segment (its stretching and flabbiness);
- inferiority of the uterine muscles caused by neurotrophic and structural-anatomical changes in it, both congenital (anomalies, malformations of the uterus, etc.) and acquired due to traumatic injuries, inflammatory processes and postoperative complications;
- stretching and flabbiness of the abdominal muscles, indirectly leading to a change in the tone of the uterus;
- prematurity;
- placenta previa;
- fetal hydrocephalus;
- pregnancy in a woman who has had multiple births;
- multiple pregnancy;
- polyhydramnios;
- congenital anomaly of the uterus;
- tumors of the uterus, cervix, vagina or ovaries;
- failure of the ligamentous apparatus of the uterus;
- oblique position of the fetus, when the pelvic end of the fetus is located in one of the mother's iliac cavities;
- low water content.
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