Breech Presentation and Delivery - Causes
The causes and predisposing factors for breech presentation include-
► Pre term labor - When labor starts when the baby is still small enough to move rather freely in the uterus. This usually occurs at 7-8 months rather than the usual 9 months.
► Uterine malformations - an unusual shape of the mother's uterus, where there is a partition in the uterus (septate uterus) or the uterus has two incomplete divisions (bicornuate), may predispose to breech presentations.
► Space occupying mass - fibroids in the lower part of the uterus may predispose to breech presentations.
► Polyhydramnios - too much of amniotic fluid may allow the fetus too much movement.
► Fetal abnormalities - like malformations of brain, neck masses and aneuploidy
► Multiple gestations (more than one fetus) - Breech presentation may result due to the limited space in the uterus.
► Multiparity - in particular grand multips. Increased maternal parity leads to increased laxity of the uterus and increases the risk of breech presentation.
► Short umbilical cord
► Placenta previa - Placental implantation over the cervical opening instead of being on the side may lead to breech presentation.
► Placental, cornual or fundal implantation - also increases the risk of breech presentation.