A delivery in breech presentation – a physiology or pathology? Historical deliberations
The breech presentation of the foetus is noted in approximately 3 percentages of all deliveries and the way they are assessed constitutes an important issue in contemporary obstetrics. In order to recognize the breech position the leopold’s holds are used as well as foetal pulse rate auscultation, cardiotocography (CTG) and ultrasonography (USG), which helps determine the foetal weight and condition. Assisting the delivery of the foetus being in the breech position requires a few exceptional methods of help among which we can find some manual ones named cowjanow – Bracht and veit – Smelly. In the case of hands abandonment, their release is achieved either through a classical method called muller’s fluctuations or lovset’s method. When the life of a foetus or a mother is at risk, manual foetus extraction (extractio manualis fetus) is recommended. Nowadays, all breech positions in primigravidas receive the recommendation for the caesarian section. when the position appears in multigravidas and the pregnancy proceeds with no complications and the foetal weight is normal, the delivery might be natural with the manual help. It, however, calls for a continuous education of the obstetrical staff namely residents.