Breech presentation and the cornual-fundal location of the placenta

Abstract

AimTo investigate the association of cornual-fundal location of the placenta and breech presentation at term delivery.MethodsThis study was conducted at the Department of Obstetrics and Gynecology, Novi Sad, in 2011. The inclusion criteria were delivery at ≥37 weeks of gestation, singleton gestation, and cornual-fundal location of the placenta determined by ultrasonography at ≥37 weeks of gestation when 3/4 or more of the placenta was in the cornual-fundal region.ResultsOut of 2750 ultrasound examinations performed, 143 showed cornual-fundal location of the placenta (frequency 5.2%). Eighty six cases had cephalic presentation (60.14%) and 57 (39.86%) had breech presentation. Of the remaining cases with non- cornual-fundal location, 2585 had cephalic presentation and 22 (0.84%) had breech presentation. The difference in the frequency of breech presentation between the cornual-fundal and non-cornual-fundal groups was significant (χ2 = 77.78, P < 0.001).ConclusionCornual-fundal location of the placenta may be an important clue in resolving the etiology of a number of cases of breech presentation at term delivery.

Anterior placental location influences onset and progress of labor and postpartum outcome

“…Fundal implantation seems to increase the incidence of prelabor rupture of membranes and a shorter duration of the third stage [19,20]. Lateral placental implantations have been associated with an increased incidence of preeclampsia, fetal distress in labor, abdominal deliveries and IUGR [12,13], while cornual implantations carries an increased risk of breech presentations [21,22]. Besides, women in labor with fetal persistent occiput posterior position had more frequently an anterior placenta [23,24].…”

Parto distócico

“…Las causas de origen fetal están dadas por malformaciones fetales como: la hidrocefalia -anencefalia, el embarazo múltiple, la prematuridad y los trastornos neuromusculares en el feto (distrofia miotónica) (Sekulić et al, 2013).…”

“…Entre las causas de origen ovular o debidas a los anejos fetales se señalan: la implantación placentaria en la región corno-fúndica, la inserción baja placentaria, polihidramnios, oligoamnios, la brevedad real o accidental del cordón, que dan lugar a acomodaciones viciosas del feto y entre ellas a la presentación pelviana (Sekulić et al, 2013).…”

Retrospective analysis of breech deliveries in tertiary care center

“…Breech presentation results from uterine anomalies, cornuofundal insertion of placenta, placenta previa, oligohydramnios, fetal growth restriction, prematurity, short umbilical cord, fetal anomalies like hydrocephalus, and swellings in front of the neck. [1][2][3] Even though breech presentation is usually associated with placenta previa, placenta previa is seen in only very small percentage of breech presentations. The commonest cause is prematurity (around 22%) as each fetal pole is of similar bulk earlier in pregnancy.…”