Health Promotion and Maintenance
53. A client, who is gravida 2, para 0, has a routine ultrasound at 18 weeks' gestation to confirm her estimated date of delivery; the ultrasound shows the fetus in a breech position. The client asks a nurse "Does this mean I will have to have a C-section?" Which response by the nurse would be most accurate?
. "If a baby is breech at this gestation, it must always be delivered by cesarean section."
. "The baby will have more room to turn as your delivery date nears."
. "You can probably deliver normally; most babies are born breech."
. "Many babies are breech at this gestation; most turn to head-down by term."
Test-Taking Tip
The key to this question is the gestational age. At 18 weeks' gestation, many fetuses are breech, and most will turn by full term.
Content Area: Maternity, Antepartum; Integrated Process: Communication and Documentation; Cognitive Level: Application; Client Need/Subneed: Health Promotion and Maintenance/Ante/Intra/Postpartum and Newborn Care
Health Promotion and Maintenance
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Answer 1 is incorrect because the fetus usually turns to vertex by term. If the fetus remains in a breech position, a cesarean delivery is the recommended method of delivery. Answer 2 is incorrect because the uterus becomes more crowded, not less, as pregnancy progresses. Answer 3 is incorrect because few fetuses (3%–4%) are in a breech position by delivery; a cesarean delivery is the recommended method of delivery for a fetus in breech presentation. Answer 4 is correct because approximately 96% of fetuses in a breech position will turn to a vertex position by term.