Patient safety

17.04.19

Routine breech scans could lower mother and baby mortality rates and save NHS money, researchers say

Scanning mothers-to-be late in their pregnancy could prevent 15,000 unexpected breech births, 4,000 emergency C-sections, and the deaths of up to eight babies a year, new research has shown.

Breech births, where a baby’s bottom or feet emerge first, can be hazardous and are tricky to diagnose, and offering late-term ultrasounds can lower the risk of morbidity and mortality for both mother and baby.

The researchers from the University of Cambridge offered breach scans to nearly 4,000 pregnant women at 36 weeks’ gestation, with 4.6% of them found to have babies in the breech position.

The analysis estimates that routine scanning nationwide could prevent around 15,000 undiagnosed breech presentations, more than 4,000 emergency caesarean sections, and the deaths of seven to eight babies every year.

The researchers said this would be possible once midwives are instructed how to perform the simple technique using inexpensive portable equipment, and that if a scan could be done for less than £12.90 then it could be cost-saving to the NHS.

Professor Gordon Smith from the university’s department of obstetrics and gynaecology and the study’s lead said: “We believe the study highlights an opportunity to identify women at increased risk of a complicated birth.

“It seems likely that screening for breech presentation near term could be introduced in a cost-effective manner, and this should be considered by the NHS and other health systems.”

In the study, the scanning at 36 weeks meant women could be offered an attempt at manually encouraging the baby to turn in the womb to a head-first position prior to labour, a method called external cephalic version.

Where this failed, or for women who declined, a planned caesarean section was arranged.

Professor Basky Thilaganathan of the Royal College of Obstetricians and Gynaecologists said: “Identification of a breech baby before labour provides an opportunity to turn the baby into the head-first position to enable a vaginal delivery, or to have a planned caesarean birth.”

He said that “current financial costs of routine scanning at 36 weeks are not insignificant” and there are “much safer options than discovering a breech baby during labour.”

 Image credit - gorodenkoff

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