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Late-Term Ultrasounds Benefit Both Mother and Child

A new study encourages late-term ultrasounds.

July 3, 2019

A recent UK study has demonstrated the life-saving difference a late-term ultrasound can make for expecting mothers and their soon-to-be-born babies.

The average pregnancy lasts around 40 weeks. By getting an ultrasound done just four weeks prior, 179 women learned their babies would be born breech—that is, feet first.

Before the ultrasound, 55 percent of these women had no reason to suspect that their babies were in breech position.    

When a baby is unexpectedly born breech, the birthing process becomes considerably more complicated and dangerous.

Continue reading to find out more regarding the importance of this study’s results, including:

  • The risks associated with breech births
  • Why getting an ultrasound at 36 weeks is dually beneficial
  • The researchers’ proposal for universal late-term ultrasounds

Breech Births

Context

In the weeks leading up to its birth, the fetus moves into its delivery position in preparation to exit through the birth canal. This is called the “delivery presentation.”   

Typically, a baby is born head-first. However, sometimes the baby will have positioned itself in a less-than-ideal delivery presentation, such as breech.

Breech births are not uncommon, occurring in around 1 out of every 25 full-term births, but they still make delivery far more difficult.

Images of different breech presentations.
There are several different breech presentations: complete, frank, and incomplete. The differentiation among these presentation is mostly based on the positioning of the fetus’s feet. Image courtesy of American Pregnancy Association.

Risks

Breech births are most dangerous when the baby is being delivered vaginally. This is because the baby’s head and shoulders are usually wider than lower portion of its body, and the cervix might not stretch enough for the upper portion of the body to safely pass through, in which case the baby might become stuck halfway through the birth.

Another hazardous circumstance that can occur during the vaginal birth of a breech baby is called umbilical cord prolapse. According to Cleveland Clinic, “In a prolapse, the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. The cord can then become trapped against the baby's body during delivery.”

Simulation uses dummies to demonstrate umbilical cord prolapse.
This simulation shows the fatal risk accompanying umbilical cord prolapse. Image from The Brookside Association.

Umbilical cord prolapses threaten the baby’s survival because if the umbilical cord becomes pinched or put under pressure in any way, oxygen might not be able to make it through the tube to the baby, resulting in birth defects or death.

If it is discovered ahead of time that the baby is presenting breech, most doctors will recommend a cesarean section. Though not without its risks, this type of delivery is preferable to a vaginal one in the case of a breech baby.

Dual Benefits of a 36-Week Ultrasound

Identifying that a baby is breech-presenting before it is born is beneficial for both the mother and the baby.

In the UK study, researchers offered the participants with breech presenting babies the option to undergo a procedure called external cephalic version, during which a doctor manually attempts to turn the baby into the head-first birthing position.

Medical professionals perform external cephalic version on a patient.
The woman might feel some discomfort as the doctor presses on her abdomen. Image courtesy of  Kinetic Fix.

External cephalic version, which has a success rate of about 58 percent, can only be done after the 36-week mark in the gestation period when the fetus has assumed its delivery presentation.

This procedure could rectify the birthing complications caused by a breech baby, saving the mother from undergoing a cesarean section and allowing the baby to pass through the birth canal head-first.

The women participating in the trial who did not want to try external cephalic version, along with those women for whom the procedure did not work, were arranged to have cesarean sections. Though traditional vaginal birth was also an alternative, none of the women chose to proceed that way.

Universal Late-Term Ultrasounds

Following the positive results of their study, researchers analyzed the cost effectiveness of universal late-term ultrasounds.

They did not reach a conclusive decision, stating, “Whether the health improvements are enough to justify the increased cost of ultrasound screening is still uncertain, mainly because the cost of ultrasound screening for presentation alone is unknown.”

The team went on to that ultrasound screening for presentation would be worthwhile, if ultrasound screening could be “sufficiently inexpensively, for example, by being used during standard midwife appointments . . .”

Summary

The results of the study are indicative of the potential difference to be made by late-term ultrasounds.

Sadly, however, this safety measure will only be available to women who have the resources to finance it.

Hopefully, in time, more adequate prenatal health care will be available to all women so that their—and their baby’s—needs will be covered.

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