Breech and malpresentation near term ⚠️ 🤰
🧠 Clinical mechanism: A non-cephalic fetal lie may change intrapartum risks and the choice between external cephalic version and planned modes of birth.
🔎 Recognise
- Breech presentation or unstable lie on abdominal examination, often confirmed on ultrasound; establish membranes, labour and fetal wellbeing.
🛟 First assessment and action
- Discuss options with the maternity team, taking account of gestation, prior birth, fetal size and maternal preference; urgent assessment in labour.
🧪 Investigations and reassessment
- Ultrasound for lie, presentation and placenta, and fetal surveillance if labour or concern.
⚠️ Pitfall / escalation
- External cephalic version is specialist-performed and inappropriate in some settings such as recent bleeding or ruptured membranes. Avoid unsupervised manoeuvres.
UK reference: Primary NHS/NICE/RCOG/GMC source.
Editorial draft, 7 November 2026: targeted source-supported educational summary, NOT independent consultant/pharmacist verification or a treatment protocol. Follow up-to-date BNF, NICE and local NHS pathways.
Related: Labour and Complications · Reduced/change in fetal movements