Breech presentation is a type of fetal malposition in which the baby is positioned in the uterus with its buttocks or feet down rather than its head down. This is the most common malposition of the fetus and occurs in approximately 3-4% of all births. Breech presentation is a risk factor for preterm delivery and is associated with increased perinatal morbidity and mortality. It can lead to an increased risk of cephalopelvic disproportion, uterine rupture, cord prolapse, and stillbirth. Women with breech presentation are more likely to have operative deliveries, either by cesarean or vacuum extraction. There are several methods used to try to resolve breech presentation, including external cephalic version (ECV) and moxibustion. ECV is a procedure in which the fetal position is changed from breech to cephalic, or head down, by pushing and rotating the fetus manually. Moxibustion is a traditional Chinese medicine technique involving the burning of mugwort near the toes of pregnant women with breech presentation. When a baby is in breech presentation, it is important to identify the risk factors and monitor the pregnancy closely. If the fetus is in a breech position at term, an obstetrician should discuss the risks and benefits of ECV or moxibustion with the mother. If these methods fail, a cesarean delivery is usually recommended.
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