ums-to-be could be routinely offered an ultrasound scan at 36 weeks to

help spot risky breech deliveries, when a baby's bottom or feet will
emerge first, say UK researchers.

Breech births can be hazardous and tricky to diagnose.

Currently, midwives and doctors tend to rely on the shape and feel of the
mother's bump to check.

Researchers estimate the scans would avoid 4,000 emergency caesareans

and eight baby deaths a year in England.
If the scans could be done cheaply enough then it should also save the NHS
money in terms of care, says the University of Cambridge team in the
journal PLoS Medicine.
 What is it like to have a home birth?
 Rise in women having induced labours

About three to four babies in every 100 are in a breech position near the end
of pregnancy.

More babies start out breech but will turn to the ideal "head-first" position by
about 36 weeks' gestation.

The researchers offered breech scans to 3,879 pregnant women:

 179 (4.6%) were found to be breech

 In more than half of these cases (96 of the pregnancies or 55%) there had been no suspicion
until the scan result

Making the diagnosis at 36 weeks meant the women could be offered an

attempt at manually encouraging the baby to turn in the womb to the head-
first position before labour - a manipulation method called external cephalic
version.

For the women who declined, or where it did not work, a planned caesarean
section was arranged. None of the women opted to attempt a vaginal breech
birth, which is possible but carries some risk.

Nineteen of the 179 women were able to deliver vaginally, 110 had a planned
caesarean and 50 needed an emergency caesarean.

Implications
Researcher Prof Gordon Smith said it should be feasible to provide the
service at a low cost, for example by making it a part of a standard midwife
appointment and using inexpensive portable ultrasound machines.
"If it was under £20 per patient then it would be cost-effective and if it could be
done for under £13 then it should save the NHS money in the long run," he
said.

Experts said the cost-effectiveness for the NHS should be explored