Abstract
Breech presentation remains a hazard for the mother and her fetus. To reduce its incidence at delivery, postural techniques have been used, among which the knee- chest position. The objective of this study was to assess the effectiveness of this position on cephalic version of breech presentation. It was a prospective randomized study in a group of 102 women with viable fetuses in breech presentation at 36 to 37 weeks of gestation. The 49 women of the intervention group assumed the knee-chest position for 15 minutes three times a day for one week. The control group had 53 cases. The study and control groups were reviewed after a week to assess the fetal presentation. The version rate was 61% and 20% in intervention and in control groups, respectively (P value = .03). This position should be advised to women with fetus in breech between 36 and 37 weeks of gestation.
Highlights
Breech presentation is a relatively common mode of presentation, found in 2% to 4% of pregnancies at term [3, 5, 12]
External cephalic version is recommended by some authors to reduce the incidence of breech presentation at term [7]
Randomized controlled trials of this method showed that it reduced the incidence of breech presentation at delivery
Summary
Breech presentation is a relatively common mode of presentation, found in 2% to 4% of pregnancies at term [3, 5, 12]. Several studies have shown an associated increased morbidity and mortality among babies in breech presentation who were delivered vaginally. External cephalic version is recommended by some authors to reduce the incidence of breech presentation at term [7]. Randomized controlled trials of this method showed that it reduced the incidence of breech presentation at delivery. External cephalic version is not harmless at term [8], and some studies carried out before term suggest that the hazards of the procedure exceed the beneficial effect of the corrected malpresentation [8]
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