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Universal late pregnancy ultrasound scans would prevent breech births and save lives, say University of Cambridge researchers


By Paul Brackley


Universal late pregnancy ultrasound scans would eliminate undiagnosed breech births, reduce the rate of emergency caesarean sections and improve the health of mothers and babies, according to research led by the University of Cambridge.

An ultrasound scan being carried out (9677324)
An ultrasound scan being carried out (9677324)

Researchers performed ultrasound screening at 36 weeks’ gestation for 3,879 women having their first pregnancies in England.

The scans led to 179 women (4.6 per cent) being diagnosed with breech presentation. In 55 per cent of these cases, there was no prior suspicion of this.

Undiagnosed breech births - where a baby’s feet or bottom emerge first at birth - increase the risk of complications and mortality. Currently, medics feel a mother’s abdomen to assess which way the baby is facing, but the success of this varies by the practitioner.

Diagnosing breech presentation at 36 weeks gave the women in the study the option of external cephalic version, where doctors attempted to turn the baby. Where this was unsuccessful, and for the women who declined the procedure, a planned caesarean section was arranged.

An ultrasound scan of a foetus (9677307)
An ultrasound scan of a foetus (9677307)

Professor Gordon Smith, from the Department of Obstetrics and Gynaecology at the University of Cambridge, who led the study, said: “We believe the study highlights an opportunity to identify women at increased risk of a complicated birth. It seems likely that screening for breech presentation near term could be introduced in a cost-effective manner and this should be considered by the NHS and other health systems.”

The analysis estimated that routine scanning in the UK could prevent about 15,000 undiagnosed breech presentations, more than 4,000 emergency caesarean sections and save the lives of seven to eight babies a year.

If a scan could be achieved for less than £12.90 a time, then it could also be cost-saving to the NHS. The researchers say this would be possible if midwives were instructed to carry out the scans using inexpensive portable equipment.

The research was funded by the National Institute for National Institute for Health Research.

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