Intrapartum Sonography of the Lower Uterine Segment in Patients with Breech-Presenting Fetuses

Lance R. Bruck; David M. Sherer

doi:10.1055/s-2007-994151

American Journal of Perinatology, Table of Contents

Am J Perinatol 1997; 14(6): 315-316
DOI: 10.1055/s-2007-994151

ORIGINAL ARTICLE

Intrapartum Sonography of the Lower Uterine Segment in Patients with Breech-Presenting Fetuses

Lance R. Bruck, David M. Sherer

Division of Maternal-Fetal Medicine, The Department of Obstetrics and Gynecology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York

Abstract

ABSTRACT

Uterine leiomyomas have been associated with an increased incidence of fetal malpresentation. Intrapartum sonographic examination, currently advocated in the assessment of patients with a breech presenting fetus includes assessment of flexion of the fetal head, sonographic estimated fetal weight, and the precise type of breech presentation. Data obtained during this evaluation is utilized in deciding the preferred mode of delivery. We report two cases in which intrapartum sonographic assessment of a women with breech-presenting fetuses at 39 and 40 weeks of gestation depicted large lower uterine segment leiomyomas, which were considered an indication for cesarean. The association between uterine leiomyomas and fetal malpresentation, and our cases support consideration of sonographic scanning of the lower uterine segment in patients being evaluated for vaginal delivery with a breech-presenting fetus.

Keywords

Breech presentation - intrapartum management - cesarean delivery - lower uterine segment leiomyoma - ultrasound

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