Session 5: Classification, nomenclature, and the risks of different types of breech presentations
- Duration: 60 Mins
- Credits: 0.15 Midwifery CEU, 1.5 ACM CPD Hours, 1.5 ACNM
- Learning Format: Webinar
- Handout: No
Abstract:
This presentation first reviews the different nomenclature systems for breech presentations and shows how they are often overlapping, contradictory, and unclear. Borrowing from Susanne Albrechtsen's work, we propose a universal nomenclature system that recognizes at least 7 types of breech presentations based on hip and knee flexion or extension. If we can adopt a clear, internationally recognized terminology, then we can better understand the risks of the various types of breech presentations.
Topics such as outcomes of vaginal footling breech, the distinction between a true “standing” footling and a “dropped foot” breech, risks of umbilical cord prolapse depending on the type of breech presentation, differences in birth mechanics between frank and nonfrank presentations, and differences in in-labor cesarean rates depending on the type of breech presentation.
Learning Objectives:
At the end of the session the participant should be able to:
Objective 1: List the various breech nomenclature systems used around the world (2-tiered system in French-speaking countries, 3-or 4-tiered system in English-speaking countries, 5- to 7-tiered system in German-speaking countries).
Objective 2: List the 7 types of breech presentation and identify hip flexion/extension and knee. flexion/extension for each type.
Objective 3: Describe the main risks and outcomes (umbilical cord prolapse, head entrapment, neonatal morbidity/mortality, rate of successful vaginal birth) for planned vaginal birth of different types of breech presentations.
Objective 4: Identify weaknesses or gaps in the existing literature on type of breech presentation.
