My worst pregnancy fear!

Legitimized!


PREGNANCY EXAM MISSES BREECH BABIES: STUDY
WebPosted Fri, 04 Aug 2006 17:03:49

---Doctors don't detect some breech babies because the usual exam to
check if a baby is facing headfirst is not sensitive enough,
researchers say.

If a baby isn't lying in the normal head-down or cephalic position, then
a vaginal delivery may be difficult or impossible.

In a breech birth, the baby comes out feet, knees or buttocks first.

If a breech position is discovered after the beginning of labour, the
risk of complications and death can increase for the mother or child.

Doctors usually assess how the baby is lying by touching the abdomen.
Researchers in Australia examined the accuracy of the technique on 1,633
women in their 35th to 37th week of pregnancy.

"Clinical examination is not sensitive enough for detection and timely
management of non-cephalic presentation," lead researcher Natasha Nassar
of the Centre for Perinatal Health Services Research in the School of
Public Health at the University of Sydney and her colleagues wrote in
Friday's issue of the British Medical Journal.

Each woman received the usual exam and then was scanned by an
ultrasound to confirm the position.

The exam missed 30 per cent of non-cephalic presentations, but
also showed false cases of breech position, the researchers reported.

If the percentage is applied to a general population of 1,000 pregnant
women, the exam would find 101 women with breech presentations, but it
would be correct in only 56 cases.

Another 24 women with non-cephalic presentations would be missed.

"Lower rates of accuracy found among overweight or obese women suggest
that formal ultrasonography in late pregnancy for these women is
required," the team said.

They note doctors may improve the accuracy of the clinical exam with
experience and feedback, and the cost-effectiveness of using ultrasounds
routinely needs to be assessed.

Copyright (C) 2006 CBC. All rights reserved.



Now then... this was something that caused me great angst with subsequent pregnancies. Nqmd tried to give me a complete breakdown about a week before her arrival by having her heartbeat come through loud and clear above the belly button. ABOVE!
My midwife called me at least four times over that weekend. Finally on Sunday afternoon she offered to set up a fetal assessment to see where baby was... yes, the gargantuan lump was obviously attached to my belly! But, to ease my fears she offered to do a medical appointment for me. She also said that she would come to the house when I went into labour. Which meant that if I'd refuse to transfer, she'd have been stuck having to help me deliver a breech baby at home. A HUGE contraindication to homebirth. I had such mixed feelings about giving her that much stress....
In the end I did not do the assessment. I just tried my best to assume baby was cephalic. After talking to my friend who delivered one of her twins breech and having a lot of "you can do it if you need to!"... I tried to feel better about it all.
The next doppler check found her ROA... head down. Bowling ball head, squishy bum... all in the right places.... well at least she was more sure about that time.
=)