podalica

Podalica is the term used in obstetrics to describe a breech presentation, in which the fetus enters the birth canal buttocks or feet first rather than head first. In podalica, the buttocks or lower part of the fetal body presents before the head.

There are several forms of breech presentation. Frank breech occurs when the hips are flexed and the knees are extended, so the buttocks present first with the legs extended toward the head. Complete breech involves the buttocks presenting with the hips and knees both flexed. Footling breech (also called an incomplete breech) occurs when one or both feet are positioned to present first, below the buttocks.

At term, breech presentations occur in about 3 to 4 percent of pregnancies, with the rate declining in higher gestational ages. Risk factors and associations include placental problems (such as placenta previa), uterine anomalies, fetal growth restriction, multiple gestations, previous breech pregnancy, and certain maternal factors. Breech is more likely when the fetus does not have enough space to turn head-down or when pelvic or placental conditions limit rotation.

Diagnosis is usually confirmed by ultrasound in late pregnancy, and sometimes by clinical examination during labor if a breech presentation is suspected. Management depends on gestational age, fetal condition, and the clinical setting. External cephalic version (ECV) can be attempted around 36 to 37 weeks to turn the fetus to a head-first position, provided there are no contraindications. If a breech presentation persists at term, cesarean delivery is commonly planned, especially in settings where vaginal breech birth carries higher risk. Vaginal breech delivery may be considered in selected cases with experienced obstetric teams and appropriate monitoring.

Overall outcomes for breech births have improved with skilled obstetric care, though risks for the fetus are generally higher than for head-first deliveries, particularly with vaginal delivery.