From the Research
To assess fetal presentation, perform a routine ultrasound scan at 35-36 weeks' gestation, as it can substantially reduce the risk of unexpected abnormal presentation in labor, and consider an additional ultrasound scan for fetal presentation when the woman presents in labor. This approach is supported by a recent study published in 2025 1, which found that routine ultrasound examination at 35-36 weeks' gestation can improve pregnancy outcomes. The study also highlights the importance of assessing fetal presentation after 36 weeks gestation to identify malpresentations like breech that may require intervention.
Some key points to consider when assessing fetal presentation include:
- The most common presentation is cephalic (head-first), occurring in about 95% of term pregnancies 1.
- Leopold's maneuvers can be used to assess fetal presentation, but may be inconclusive or difficult in cases of maternal obesity or polyhydramnios.
- Ultrasound provides a definitive assessment of fetal presentation and can be used to confirm findings or when manual examination is inconclusive.
- Regular assessment during the third trimester allows for timely planning of delivery method if non-cephalic presentations persist.
- Intrapartum sonography can be used to evaluate fetal head position and attitude during labor, and has been shown to be more accurate than vaginal examination in some cases 2, 3.
- Universal late-pregnancy ultrasonography has been shown to be cost-effective in identifying breech presentations and reducing the risk of undiagnosed breech presentation in labor 4.
Overall, the use of ultrasound to assess fetal presentation is a crucial component of prenatal care, and can help identify potential complications early on, allowing for timely intervention and improved outcomes. The most recent and highest quality study supports the use of routine ultrasound scan at 35-36 weeks' gestation to assess fetal presentation 1.