Checks miss breach babies

Last updated at 00:01 04 August 2006


Doctors are failing to spot dangerous breech pregnancies because physical examinations are not sensitive enough, experts warned today.

A study found that around a third of breech positions could be missed because a routine examination merely involves feeling the stomach.

Australian researchers studied 1,633 women at 35 to 37 weeks gestation who attended an obstetric hospital in Sydney.

Each woman underwent a physical examination to assess the position of their baby, and then had an ultrasound scan to confirm the diagnosis.

The researchers found that the physical examination detected just 70% of the breech positions.

Detection rates were also lower among women who were overweight or obese, the study, published in the British Medical Journal, found.

During the late stages of pregnancy, babies move into a head-down position ready for birth but some babies fail to move correctly into position, making normal vaginal delivery much more difficult.

Complications and the chance of the child dying are higher when breech birth is detected following the onset of labour, studies have shown.

Many women carrying breech babies are offered a caesarean section after a study published in 2000 showed that the risk of death or serious harm to child was more than three times lower in those who had the operation.

The researchers behind the Australian study said that in a general maternity population of 1,000 women, the physical examination alone would identify 101 women as having a breech baby.

That, however, would only be a correct diagnosis for 56 of the women and 24 women having a breech baby would be missed altogether, the authors said.

They argued that routine ultrasound scans would improve detection rates and suggested such scans should be introduced for overweight or obese women, but noted that this would increase costs.

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