Transverse Breech Questions

Hello,

I am new to posting to this NG. I participate mainly in
alt.infertility.pregnancy. Anyway, I am 36 weeks pregnant as of today. I
had an u/s yesterday and my baby is in transverse breech position. It was
suggested to me to post about this in this NG by another member in
alt.infertility.pregnancy.

Has anyone had experience with this? Any advise on what could work to help
turn the baby? Has anyone here had a c-section due to this type of breech
presentation? I am having another u/s next week at 37 weeks, and if my son
is still breech, I will have a planned c-section just before 39 weeks. It
is my understanding, from all of my online research, that it is difficult
for a transverse breech baby to move to correct position this far along.

This is my first pregnancy, after years of trying to conceive, and I am 36
years old. I have PCOS and this pregnancy was high risk during the
beginning of my pregnancy due to a subchorionic hemorrhage (sch), where I
pretty much bled every day during the first 4 months. It has been nice
having a normal, low risk pregnancy after the SCH cleared up... until this
happened!

Any advise will be very appreciated. Thanks for your help!

Adela
EDD 11-24-05
(or 11-15-05 if I have a c-section)

Purple Gal wrote:
Hello,

I am new to posting to this NG. I participate mainly in
alt.infertility.pregnancy. Anyway, I am 36 weeks pregnant as of today. I
had an u/s yesterday and my baby is in transverse breech position.

Just to pick a nit (not that it's too relevant, but it
might be an issue if you're doing online searches), transverse
is not breech. Breech means head up, and transverse means
side-lying, though breech and transverse are often lumped
together in discussions.

Has anyone had experience with this? Any advise on what could work to help
turn the baby?

You could try some of the techniques listed at
http://www.gentlebirth.org/archives/breech.html

Has anyone here had a c-section due to this type of breech
presentation?

If you cannot get the baby out of a transverse
position, a c-section is the only viable option.

I am having another u/s next week at 37 weeks, and if my son
is still breech, I will have a planned c-section just before 39 weeks.

Hmm...why wouldn't an external cephalic version
be attempted? Thirty-seven weeks is a good time to attempt
one, and the success rate is pretty good. My last baby was
persistently breech at 37 weeks and I had an external version
which was successful. I'd take that over a planned c-section
any day of the week. There are situations in which ECV is
not possible, but I would certainly ask about it. It is also
a very good idea to search around for a care provider who
is very experienced and successful with ECV. Many caregivers
don't do very many versions, and it's quite an art form.
You don't have to have your regular OB or midwife do it.
Ask around and find out who is really good in your area,
and go with that person.

It
is my understanding, from all of my online research, that it is difficult
for a transverse breech baby to move to correct position this far along.

Nah, there are still options. Don't give up hope
yet, but do try something. Just wishing that it would
change may not do much for you.

Best wishes,
Ericka

Just to pick a nit (not that it's too relevant, but it
might be an issue if you're doing online searches), transverse
is not breech. Breech means head up, and transverse means
side-lying, though breech and transverse are often lumped
together in discussions.

I wondered if she meant oblique, half way between transverse and breech.

If you cannot get the baby out of a transverse
position, a c-section is the only viable option.

absolutely, though I did read an amazing story where for some reasonthe
first thing that appeared when pushing was an arm, the midwife was very calm
and instead of calling an ambulance and rushing her to hospital for a
c-section managed to insert her hand in and gently move the arm back in and
rotate the baby round for a vaginal breech delivery, amazing, but not
recommended that you intend to do things that way!

Hmm...why wouldn't an external cephalic version
be attempted? Thirty-seven weeks is a good time to attempt
one, and the success rate is pretty good. My last baby was
persistently breech at 37 weeks and I had an external version
which was successful. I'd take that over a planned c-section
any day of the week. There are situations in which ECV is
not possible, but I would certainly ask about it. It is also
a very good idea to search around for a care provider who
is very experienced and successful with ECV. Many caregivers
don't do very many versions, and it's quite an art form.
You don't have to have your regular OB or midwife do it.
Ask around and find out who is really good in your area,
and go with that person.

I wonder if the SCH history might be a problem, but then if the version is
attempted in hospital emergency c-section is an option.

If the baby turns to breech a vaginal delivery is still possible, you'd have
to take advice from your caregivers, as many are not prepared to do breech
deliveries and if they don't want to do it, the safest option probably is a
c-section, because if they don't want to do it, they haven't got the
experience.

Cheers

Anne

In article ,
"Purple Gal" wrote:

Hello,

I am new to posting to this NG. I participate mainly in
alt.infertility.pregnancy. Anyway, I am 36 weeks pregnant as of today. I
had an u/s yesterday and my baby is in transverse breech position. It was
suggested to me to post about this in this NG by another member in
alt.infertility.pregnancy.

Has anyone had experience with this? Any advise on what could work to help
turn the baby?

My first was transverse, and I had him turned at 38 weeks (or so). The
process is called an external version. It was done in a hospital, with
me prepared for a c-section in case it caused too much distress -- which
was good, because it meant I had an epidural for it and it didn't hurt
at all. It all went well, and my son was born vaginally at 41 1/2 weeks.
--
Sara
accompanied by TK, number two, due in April of 2006

Anonymama wrote:

My first was transverse, and I had him turned at 38 weeks (or so). The
process is called an external version. It was done in a hospital, with
me prepared for a c-section in case it caused too much distress -- which
was good, because it meant I had an epidural for it and it didn't hurt
at all. It all went well, and my son was born vaginally at 41 1/2 weeks.

Versions can be very different depending on the
situation and the care provider. However, in general
one should realize that there *are* options. Many care
providers now seem to default to the whole enchilada,
with epidural, tocolytics, an operating theater
standing by, and a plan to induce immediately if the
version is successful. Particularly in situations the look
favorable for version, however, you don't have to
go that route if you don't want to. By far, the
most common complication (though it doesn't happen
frequently) is that the version will throw you into
labor. No big rush in that case. Even less often,
it can result in your membranes rupturing, which
can lead to a risk of cord prolapse if the baby
is still out of position. This is something that
an experienced caregiver should be able to handle
just fine. The rare occurence, and the one you
want the backup handy for, is just in case the version
causes a placental abruption. It is not absolutely
necessary, however, to agree to all the interventions
before the version for this very rare complication.
It would mean an emergency c-section, but they can
accomplish that without pre-placing an epidural
and all that (though it likely would mean general
anesthesia for the c/s).
In my case, I didn't want all those interventions
for my version, as long as safety wasn't compromised.
My situation was favorable (plenty of amniotic fluid,
placenta and cord in a good place, etc.) and the OB
who did it felt fine doing it without the interventions.
I had no IV, no tocolytics, no epidural. They checked
things out with an u/s, monitored the baby for a bit,
greased up my belly, turned the baby in less than 30
seconds, checked again with u/s, monitored for a little
bit to make sure the baby wasn't in distress, and I
was done. It was not particularly painful at all--
just some pressure. The OB who did my version was
the best in the area, and I think his skill was a
major factor in it playing out that way.
That's not to say that all version will turn
out that way. My agreement with the OB was that
we'd try it low intervention first. If that didn't
work or they had to push so hard that it was too
painful, we'd back off and reconsider more interventions
and balance those against the possibility of a
c-section for breech or a vaginal breech birth (this
OB would do vaginal breech births in some situations).
Either would have meant giving up my midwives and
plans for a homebirth. Fortunately for me, none of
that was necessary. Given how easy mine way, I'd
have been really upset to think of going through
an epidural and all that for it. Placing the epidural
would have taken longer and been more painful than
the version was! ;-) But again, it's not like that
for everyone, so I'm not saying that no one should
have an epidural for a version. I'm just suggesting
that one might consider trying it without in a
favorable situation first.

Best wishes,
Ericka

In article ,
Ericka Kammerer wrote:

The OB who did my version was
the best in the area, and I think his skill was a
major factor in it playing out that way.

I think you were lucky. I had the impression that versions were unusual
at the hospital where I got mine done (St. Luke's Roosevelt in
Manhattan, not exactly a rural health clinic!). Maybe it was just
because it's a teaching hospital, but I felt like the doctor who was in
charge (not my OB GYN, although she was there too) was the only person
who'd done one at all recently.

My OB GYN acted like she was humoring me by doing the version and not
heading straight in for a c-section. Bah. I'm glad she won't be my
doctor this time around.
--
Sara
accompanied by TK, number two, due in April of 2006

"Ericka Kammerer" wrote in message
...

Just to pick a nit (not that it's too relevant, but it
might be an issue if you're doing online searches), transverse
is not breech. Breech means head up, and transverse means
side-lying, though breech and transverse are often lumped
together in discussions.

You are correct... I should have referred to it as transverse lie.

You could try some of the techniques listed at
http://www.gentlebirth.org/archives/breech.html

Thank you for the website. I tried several of the techniques already. I
hope they help!


Hmm...why wouldn't an external cephalic version
be attempted? Thirty-seven weeks is a good time to attempt
one, and the success rate is pretty good. My last baby was
persistently breech at 37 weeks and I had an external version
which was successful. I'd take that over a planned c-section
any day of the week. There are situations in which ECV is
not possible, but I would certainly ask about it. It is also
a very good idea to search around for a care provider who
is very experienced and successful with ECV. Many caregivers
don't do very many versions, and it's quite an art form.
You don't have to have your regular OB or midwife do it.
Ask around and find out who is really good in your area,
and go with that person.

I was planning on talking to my doctor about trying this if he is still
breech next week.

It is my understanding, from all of my online research, that it is
difficult for a transverse breech baby to move to correct position this
far along.

Nah, there are still options. Don't give up hope
yet, but do try something. Just wishing that it would
change may not do much for you.

Thank you so much for your response.. I appreciate it!

Adela

Best wishes,
Ericka

"Anne Rogers" wrote in message
...

I wondered if she meant oblique, half way between transverse and breech.

He is definately transverse/side lying. I should have called it transverse
lie... sorry for the confusion.

If you cannot get the baby out of a transverse
position, a c-section is the only viable option.

absolutely, though I did read an amazing story where for some reason the
first thing that appeared when pushing was an arm, the midwife was very
calm and instead of calling an ambulance and rushing her to hospital for a
c-section managed to insert her hand in and gently move the arm back in
and rotate the baby round for a vaginal breech delivery, amazing, but not
recommended that you intend to do things that way!

That sounds painful and dangerous!!!

Hmm...why wouldn't an external cephalic version
be attempted? Thirty-seven weeks is a good time to attempt
one, and the success rate is pretty good. My last baby was
persistently breech at 37 weeks and I had an external version
which was successful. I'd take that over a planned c-section
any day of the week. There are situations in which ECV is
not possible, but I would certainly ask about it. It is also
a very good idea to search around for a care provider who
is very experienced and successful with ECV. Many caregivers
don't do very many versions, and it's quite an art form.
You don't have to have your regular OB or midwife do it.
Ask around and find out who is really good in your area,
and go with that person.

I wonder if the SCH history might be a problem, but then if the version is
attempted in hospital emergency c-section is an option.

The SCH was caused by my placenta not attaching 100% and is not related to
the transverse lie. The SCH caused alot of bleeding, but it healed up at 18
weeks. One night, it was so bad... I was rushed to the hospital thinking I
was miscarrying. I soaked several pads in an hour.

If the baby turns to breech a vaginal delivery is still possible, you'd
have to take advice from your caregivers, as many are not prepared to do
breech deliveries and if they don't want to do it, the safest option
probably is a c-section, because if they don't want to do it, they haven't
got the experience.

Thank you for your response, Anne... I appreciate it!

Adela

Cheers

Anne

Thank you so much for sharing your experience. I am definately going to
discuss this option with my OB if he is still breech next week at my 37 week
u/s.

Adela

"Anonymama" wrote in message
...
In article ,

My first was transverse, and I had him turned at 38 weeks (or so). The
process is called an external version. It was done in a hospital, with
me prepared for a c-section in case it caused too much distress -- which
was good, because it meant I had an epidural for it and it didn't hurt
at all. It all went well, and my son was born vaginally at 41 1/2 weeks.
--
Sara
accompanied by TK, number two, due in April of 2006

absolutely, though I did read an amazing story where for some reason the
first thing that appeared when pushing was an arm, the midwife was very
calm and instead of calling an ambulance and rushing her to hospital for
a c-section managed to insert her hand in and gently move the arm back in
and rotate the baby round for a vaginal breech delivery, amazing, but not
recommended that you intend to do things that way!

That sounds painful and dangerous!!!

probably, but probably less dangerous than trying to stop the mother from
pushing whilst an ambulance was caused, I'm off to hunt for the story, I
can't remember how they got into the situation, it was very inspiring, so
see what was basically an emergency being dealt with so calmly and with a
good outcome.

Anne