This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in

Diagnosis and management

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

NICE suggest that (1):

  • if breech presentation at term
    • all women who have an uncomplicated singleton breech pregnancy at 36 weeks should be offered external cephalic version. Exceptions include women in labour and women with a uterine scar or abnormality, fetal compromise, ruptured membranes, vaginal bleeding and medical conditions
    • where it is not possible to schedule an appointment for external cephalic version at 37 weeks, it should be scheduled at 36 weeks.

Diagnosis is by:

  • palpation
  • auscultation: position of the foetal heart
  • vaginal examination
  • ultrasound - able to determine type of breech


  • caesarian or vaginal delivery decision is based on the type of breech, any causative factors, and the results of pelvimetry etc
  • external cephalic version is possible, but this carries the risk of abruption
  • vaginal delivery must be carefully monitored and supervised by an obstetrician
  • often the decision is heavily influenced by maternal preference

Note that planned caesarian section had a lower risk for perinatal mortality and serious morbidity than planned vaginal birth in breech presentation (2) in a randomised trial comparing the two forms of delivery.


  1. NICE (2008). Antenatal care.
  2. Hannah ME et al, for the Term Breech Trial Collaborative Group (2000). Planned caesarian section versus planned vaginal birth for breech presentation at term: a randomised trial. Lancet, 356, 1375-83.

Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.