Offering universal late pregnancy ultrasounds at 36 weeks would benefit mothers and babies and could be cost-saving, according to research from the University of Cambridge and the University of East Anglia (UEA). The study, led by the University of Cambridge in collaboration with UEA and published in PLOS Medicine. shows that an additional routine ultrasound could eliminate undiagnosed breech presentation of babies, lower the rate of emergency caesarean sections, and improve the health of mothers and babies.

Undiagnosed breech presentation increases risks for the mother and baby during childbirth. By routinely using ultrasound scanning, undiagnosed breech presentations in labor could be avoided, lowering the risk of complications, including death, for both mother and baby.

To complete the study, the research team performed screening ultrasounds at 36 weeks gestation in 3,879 women having first pregnancies in England. A total of 179 women (4.6 %) were diagnosed with breech presentation by the scan. However, in over half of these cases (55 %) there was no prior suspicion that the baby was in the breech position.

Making the diagnosis at 36 weeks allowed women to opt for an attempt at turning the baby, called external cephalic version. For the women who declined this procedure, or where it was unsuccessful, a planned caesarean section was arranged. None of the women opted to attempt a vaginal breech birth, which is known to be associated with an increased risk of complications, particularly in first pregnancies.

Gordon Smith, professor of obstetrics and gynecology at the University of Cambridge and chief investigator of the study, says: “We believe the study highlights an opportunity to identify women at increased risk of a complicated birth. It seems likely that screening for breech presentation near term could be introduced in a cost-effective manner and this should be considered by the NHS and other health systems.”