What are the key considerations for managing a patient presenting in labour with a breech presentation?

When managing a patient presenting in labour with a breech presentation, key considerations include:

• Discussing the mode of birth options with the woman, including the benefits and risks of vaginal breech birth versus caesarean section, ensuring she understands the potential for serious medical problems for both mother and baby associated with each option ⁴.
• Offering a choice between continuing labour with a vaginal breech birth or opting for caesarean section, respecting the woman's informed decision ⁴.
• Explaining that caesarean section may reduce the risk of serious medical problems for the baby, especially if performed early in labour ⁴.
• Assessing labour progress according to NICE intrapartum care guidelines to ensure safe monitoring and timely decision-making ⁴.
• Providing continuous fetal heart rate monitoring with cardiotocography during labour to detect fetal distress early, as breech presentation carries increased risk ⁴.
• Ensuring clear, sensitive communication tailored to the woman’s needs and preferences, supporting shared decision-making throughout labour ³.
• Preparing for potential complications by having experienced staff available and facilities ready for emergency caesarean section if needed ⁴.

These considerations aim to balance maternal and fetal safety while respecting the woman’s preferences and informed choices during labour with a breech presentation.