FRIDAY, Aug. 4 (HealthDay News) -- Non-cephalic, including breech, presentation fetuses are not accurately diagnosed in later pregnancy by clinical examination and ultrasound may be required, particularly for obese women, according to a study published online Aug. 4 in BMJ.
Natasha Nassar and colleagues at the University of Sydney in Australia, conducted a study of 1,633 women with a singleton pregnancy. The patients were examined clinically between 35 and 37 weeks' gestation to ascertain the position of the fetus, and the diagnosis was confirmed with ultrasound.
In all, 130 (8 percent) of women were identified by ultrasound as having non-cephalic presentation, including 103 (6.3 percent) with breech and 27 (1.7 percent) with transverse or oblique-lying fetuses. However, only 70 percent of non-cephalic pregnancies were identified by clinical examination. Women with lower body mass index and with a previous history of pregnancy were easier to accurately diagnose.
The authors suggest that routine ultrasound scans to assess fetal presentation would improve accuracy of diagnosis but runs the risk of lowering the skills of care providers and also depends on the cost-benefit ratio.
"However, lower rates of accuracy found among overweight or obese women suggest that formal ultrasonography in late pregnancy for these women is required," the authors write.