Giving all pregnant women an extra ultrasound at 36 weeks could prevent thousands of emergency C-sections each year
- A breech birth is when a baby is naturally born feet-first instead of head-first
- Pregnant women typically receive an ultrasound scan at eight to 14 weeks
- They then receive another between 18 and 21 weeks, under current guidelines
- But another ultrasound at 36 weeks could mean an end to breech babies
- Breech babies are usually delivered by emergency Caesarean, experts warn
Women could be spared from risky emergency Caesareans if they were given an extra ultrasound in late pregnancy, a new study has revealed.
Pregnant women typically receive an ultrasound scan at eight to 14 weeks and then again between 18 and 21 weeks.
But experts say another ultrasound at 36 weeks of pregnancy could mean an end to surprise breech babies.
These breech babies, which are the wrong way round in the womb, are usually delivered by emergency Caesarean, which carries a higher risk of bleeding for a mother.
A breech birth is when a baby is naturally born bottom-first or feet-first instead of head-first
The additional ultrasound could instead allow for doctors to try to turn a baby around the right way, or for a safer planned Caesarean.
Researchers, looking at late ultrasounds given to almost 4,000 first-time mothers, found one in 40 scans detected a breech baby which doctors would not have identified.
If used routinely across the UK, they conclude it could detect almost 15,000 breech babies a year and save more than seven children’s lives.
Dr Alexandros Moraitis, a co-author of the study from the University of Cambridge, said: ‘These scans could be done cheaply during a routine midwife’s visit with a portable ultrasound.
‘An additional cost of the scan would be cancelled out by the saving of detecting a breech baby and avoiding an emergency Caesarean.
‘This could be a huge relief for the thousands of mothers who would know whether their baby was breech and have the option to try to turn it around and have a normal delivery.
WHAT IS A BREECH BIRTH?
A breech birth is when a baby is naturally born bottom-first or feet-first instead of head-first.
It affects around three to four per cent of pregnancies in the UK.
Babies are often in different positions throughout the course of a pregnancy but will usually end up head-down by the time they are due.
Birthing the baby backwards is not necessarily dangerous and mothers may be able to do so in certain circumstances.
However, it carries a higher risk of the baby getting stuck in the birth canal or their oxygen supply being cut off because of pressure on the umbilical cord.
Medics might want to try and rotate the baby – an external cephalic version – which can be done by hand.
Or, if a vaginal birth isn’t safe, the mother may be advised to have a caesarean section.
Options are usually discussed if the baby is still in the breech position by the 36th week of pregnancy.
‘It could also save them the extreme stress of having an emergency Caesarean for an unexpected breech baby.’
Doctors currently determine if a baby is upside down by feeling for its head and body through a woman’s abdomen.
But the study found this approach worked only 44 per cent of the time, missing more than half of breech babies.
In the 3,879 first-time English mothers given ultrasounds, 179 of them had breech babies, of which 96 were undetected by doctors.
The breech babies not found by doctors could have their lives saved by an ultrasound, due to the risk of death from becoming stuck in the birth canal if they were born naturally feet or buttocks first.
More commonly, mothers were spared emergency Caesareans, which carry a higher risk of bleeding.
For 12 of the 179 breech babies, doctors were able to turn them around just by applying pressure to a woman’s abdomen so that her baby somersaulted into the right position. Other studies suggest this technique could work for as many as half of pregnant women.
The study also saw almost two-thirds of women given safer planned Caesareans.
Researchers, whose study is published in the journal PLOS Medicine, say the procedure could be entirely cost-effective, despite the cost of an ultrasound, when the savings from unnecessary emergency Caesareans are taken into account.
Around one in 25 woman have breech babies, and less than a tenth of these turn themselves around naturally.
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