Timely Ultrasound Can ID Undiagnosed Breech Presentations

FRIDAY, April 7, 2023 (HealthDay News) -- Routine third-trimester ultrasound or point-of-care ultrasound (POCUS) is associated with a reduction in the proportion of undiagnosed term breech presentations, according to a study published online April 6 in PLOS Medicine.

Samantha Knights, from the Norfolk and Norwich University Hospitals NHS Foundation Trust in the United Kingdom, and colleagues conducted a retrospective cohort study to compare the impact of routine third trimester ultrasound or POCUS with standard antenatal care on the proportion of all term breech presentations that were undiagnosed at term. Data were included for pregnancies grouped according to whether they received a routine third-trimester scan at St. George's Hospital (SGH) or POCUS at Norfolk and Norwich University Hospitals (NNUH). There were 16,777 and 7,351 births in SGH and 5,119 and 4,575 in NNUH before and after implementation of routine third-trimester scans or POCUS, respectively.

The researchers found that across all groups, the rate of breech presentation in labor was consistent (3 to 4 percent). The percentage of all term breech presentations that were undiagnosed was 14.2 and 2.8 percent before and after implementation of universal screening, respectively, in the SGH cohort. The corresponding proportions were 16.2 and 3.5 percent in the NNUH cohort. The rate of undiagnosed breech was 71 percent lower after implementation of universal ultrasound and 69 percent lower after implementation of universal POCUS (relative risks, 0.29 and 0.31, respectively).

"A policy of either third trimester ultrasound or POCUS by health care providers could be effective in reducing the proportion of all term breech presentations that were undiagnosed at birth with an associated improvement in neonatal outcomes," the authors write.

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