lgher

7+ Year Member
Aug 10, 2009
21
2
Status
Resident [Any Field]
Hi,

I'm an anesthesiologist in Canada...I had a patient booked for primary section for breech. Their last ultrasound was 2 weeks ago. The surgeon palpated the fetuses position, and although they didn't seem 100% sure, felt the baby was still breech..(he wasn't, which was evident during the c section)

This made me wonder:
Are there any clear guidelines about confirmation of breech position prior to C section for breech?

eg. should an ultrasound have been done day of? or is palpation considered adequate for confirmation of breech?

Thanks for your help..
 

Dr G Oogle

2+ Year Member
Mar 8, 2017
179
207
if they weren't sure and the patient would have preferred a vaginal birth in the event the fetus flipped then for sure an ultrasound should have been performed, palpation is not adequate, like i used to tell my interns, "heads feel like butts and butts feel like heads"; otherwise there are no hard and fast guidelines, assuming the patient was full term the odds that a fetus will flip spotaneously from breech to cephalic after 36 weeks are slim, unless it was an unstable lie, in which case the fetus could even flip in labor before rupture of membranes, some would recommend doing an US a day or two before surgery to check positi on but not everyone will do that, at least in the US; not sure if there are more specific guidelines in Canada
 

anonperson

10+ Year Member
Jun 26, 2008
641
561
Status
Attending Physician
Hi,

I'm an anesthesiologist in Canada...I had a patient booked for primary section for breech. Their last ultrasound was 2 weeks ago. The surgeon palpated the fetuses position, and although they didn't seem 100% sure, felt the baby was still breech..(he wasn't, which was evident during the c section)

This made me wonder:
Are there any clear guidelines about confirmation of breech position prior to C section for breech?

eg. should an ultrasound have been done day of? or is palpation considered adequate for confirmation of breech?

Thanks for your help..
The doctor is just incompetent and/or lazy.
What hospital doesn't have an ultrasound available in this day and age?

I've trained at 3 institutions (academic and community) and am working out in the community. Every time there was a section for breech, a scan was done immediately beforehand.

Could easily be sued and rightly so,especially if the patient experienced a complication from the section.