Footling Breech Presentation: Causes, Diagnosis, and Management
Footling Breech Presentation: Causes, Diagnosis, and Management
Footling breech presentation is a rare type of breech birth where one or both of the baby’s feet come out first instead of the buttocks or head. It is considered a high-risk condition in pregnancy, especially for vaginal delivery, due to the risk of complications like cord prolapse and birth trauma.
🔎 What is Footling Breech Presentation?
Normally, babies are positioned head-down (cephalic presentation) before birth. In breech presentations, the baby’s buttocks or feet come first. In a footling breech, one or both feet slip into the birth canal ahead of the rest of the body.
| Type of Breech | Description |
|---|---|
| Frank Breech | Buttocks first, legs up towards head |
| Complete Breech | Buttocks first, legs folded at knees |
| Footling Breech | One or both feet come out first |
📌 Causes of Footling Breech
- Premature delivery (before 37 weeks)
- Too much amniotic fluid (polyhydramnios)
- Multiple pregnancies (twins or more)
- Placenta previa (low-lying placenta)
- Abnormal shape of the uterus
- Previous breech pregnancy
⚠️ Risk Factors
- History of breech delivery
- Maternal pelvic abnormalities
- Premature rupture of membranes
- Uterine fibroids or septum
- Smoking during pregnancy (linked with abnormal fetal positioning)
🩺 Symptoms & Diagnosis
Most women may not notice symptoms, but healthcare professionals can detect it through:
- Physical examination: Fetal head felt in upper abdomen, irregular fetal lie.
- Ultrasound: Confirms fetal presentation.
- Vaginal examination: Presence of fetal foot in the cervix.
🚑 Complications of Footling Breech
- Umbilical cord prolapse (cord slips out before baby)
- Obstructed labor
- Fetal distress
- Head entrapment
- Birth trauma (fractures, nerve injuries)
🧾 Management & Treatment Options
Management depends on gestational age, fetal well-being, and maternal condition.
✅ Before Labor
- External Cephalic Version (ECV): Turning baby manually to head-first at 36–37 weeks.
- Close monitoring with ultrasound.
- Avoid unnecessary vaginal examinations to prevent cord prolapse.
✅ During Labor
- Cesarean section (C-section): Recommended in most cases due to high risk.
- Vaginal breech delivery only in rare, carefully monitored situations.
📊 Prognosis
With proper medical care, outcomes are generally favorable. However, cesarean delivery is often the safest option for both mother and baby.
❓ Frequently Asked Questions (FAQs)
1. Is footling breech common?
No. It is rare, occurring in less than 1% of pregnancies at term.
2. Can a footling breech be delivered vaginally?
It is not recommended due to high risks. Cesarean section is considered the safest method.
3. What increases the risk of footling breech?
Prematurity, multiple pregnancies, and uterine abnormalities increase the likelihood.
4. Can ECV correct footling breech?
Yes, in some cases, ECV can turn the baby into a head-first position before labor starts.
📌 Key Takeaway
Footling breech presentation is a rare but serious pregnancy complication. Early detection, proper monitoring, and timely medical intervention (usually via C-section) are essential to ensure the safety of both mother and baby.
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