noncephalic

Noncephalic is an obstetric term describing a fetus presenting with a part other than the head as the leading portion at birth. The term comes from Latin non- “not” and cephalic “of the head.” Noncephalic presentations include breech (the buttocks or feet entering first), shoulder or transverse lie, and, less commonly, face or brow presentations.

Cephalic presentation is the norm at term, with noncephalic presentations accounting for a minority of pregnancies. Breech is the most common noncephalic presentation at term, occurring in about 3 to 4 percent of pregnancies; the rate is higher earlier in gestation. Risk factors for noncephalic presentation include prematurity, placenta previa or placental abruption, uterine anomalies or scarring, multiparity, fetal anomalies, and polyhydramnios.

Detection and management: Noncephalic presentation is detected by ultrasound and clinical examination. If a noncephalic presentation is identified near term, obstetricians may attempt external cephalic version (ECV) around 37 weeks to turn the fetus to cephalic presentation, with success rates varying roughly 40 to 60 percent and with possible contraindications such as placenta previa, uterine scars, fetal distress, or multiple gestation. If ECV is unsuccessful or not suitable, planned cesarean delivery is commonly recommended for breech presentation; in selected cases, vaginal breech delivery may be considered by experienced teams with careful obstetric assessment.

Noncephalic presentations carry higher risks of certain intrapartum complications and neonatal outcomes in some settings compared with cephalic births; modern management aims to tailor delivery method to presentation, gestational age, fetal status, and maternal factors.