BMJ  2006;333:705 (30 September), doi:10.1136/bmj.333.7570.705-b

Letter

Clinical examination for non-cephalic presentation

Royal College of Midwives' response to research

The first 150 words of the full text of this article appear below.

EDITOR—Nassar et al conclude that a third of breech pregnancies are missed using abdominal palpation.1 The Royal College of Midwives recommends caution before using this research to advocate more reliance on technological solutions rather than clinical examination.

This study was carried out in Australia, where antenatal care practices are different from those in the United Kingdom. In the United Kingdom midwives provide most maternity care and are highly trained in abdominal palpation, defining the position of the fetus.

Good clinical skills are important in assessing the fetal position during pregnancy. Some babies in breech position may be missed, which reinforces the need to use this research to inform current education and training of midwives and obstetricians. As the authors say, to rely further on increasing technology such as ultrasound scans may reduce practitioners' clinical skills. Some clinicians in the study may not have been as vigilant as they . . . [Full text of this article]

Sue Macdonald, education and research manager

Royal College of Midwives, London W1G 9NH sue.macdonald@rcm.org.uk


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Relevant Article

Diagnostic accuracy of clinical examination for detection of non-cephalic presentation in late pregnancy: cross sectional analytic study
Natasha Nassar, Christine L Roberts, Carolyn A Cameron, and Emily C Olive
BMJ 2006 333: 578-580. [Abstract] [Full Text] [PDF]

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