# Abnormal fetal presentation

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Breech Presentation - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK448063/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class WD71.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care
- Abnormal fetal presentation - disease-level clinical article (abnormal-fetal-presentation-full.txt)

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
ABNORMAL FETAL PRESENTATION
Sources: Breech Presentation - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK448063/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class WD71.00 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against No dose - referral pathway, no medicine given in primary care,
               Abnormal fetal presentation - disease-level clinical article
               (abnormal-fetal-presentation-full.txt)  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SIGNS - what you find (4)
    - A hard, round, mobile mass palpable at the uterine fundus, with no presenting part felt low in
      the pelvis  [skin nodule]
    - Cervical exam may find no presenting part felt, or a foot palpable instead
    - For an engaged breech, soft fetal buttock tissue may be felt on cervical exam
    - In labor, buttock tissue can be mistaken for the caput of the vertex, a trap for the examiner
  TESTS (3)
    - Ultrasound confirms the diagnosis after a suspicious Leopold and cervical exam
    - Sonography documents fetal lie and which part is presenting
    - Workup records breech subtype, head flexion, estimated weight, fluid volume, placental site,
      and anatomy
  IF NOT THIS - what else fits (5)
    - Face or brow presentation can mimic breech findings
    - Structural fetal anomalies or intrauterine fetal death are on the differential
    - Grand multiparity and multiple gestation pregnancies are considered
    - Oligohydramnios and abnormal maternal pelvic anatomy factor into the differential
    - Preterm labor, primigravida status, and uterine anomalies round out the differential
  Source  StatPearls "Breech Presentation" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Breech or other non-head-down presentation near term; the GP recognises this on
            examination and refers to obstetrics for assessment of turning the baby or delivery
            planning. - Refer, with advice
   Peds     Adult-only condition - paediatric section not applicable
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Breech or other non-head-down presentation near term; the GP recognises this on
            examination and refers to obstetrics for assessment of turning the baby or delivery
            planning.
   Caution  RED FLAG - Fetal distress or vaginal bleeding in the presence of malpresentation: assess
            urgently and refer.
            Abnormal presentation with ruptured membranes or active labour needs immediate obstetric
            referral due to the risk of cord prolapse.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - A high risk of umbilical cord prolapse is associated with incomplete or
            footling breech presentation.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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