INTEGRATING BASIC SCIENCE AND CLINICAL SKILLS IN MIDWIFERY CARE OF THIRD TRIMESTER PREGNANT WOMEN WITH BREECH MALPRESENTATION

Abstract

Breech malpresentation in the third trimester of pregnancy represents a significant obstetric complication that contributes to elevated perinatal morbidity and mortality. This study aims to evaluate the implementation of evidence-based comprehensive midwifery care by integrating basic biomedical sciences (Basic Midwifery Science II and III) and Fundamental Midwifery Clinical Skills (KDPK). The method employed is a clinical case study of Mrs. A, a 26-year-old primigravida (G1P0A0) at 34 weeks of gestation, managed at the Healthcare Facility (Faskes) of PT Panca Surya Agrindo. Clinical data collection involved anamnesis, abdominal palpation via Leopold maneuvers, and fetal hemodynamic monitoring using a Doppler transducer. Physical examination confirmed a breech presentation with a fundal height of 30 cm and a normal fetal heart rate of 140 beats per minute. A non-invasive, conservative positional intervention was applied, instructing the patient to perform the knee-chest position. This posture elevates the maternal pelvis above the thoracic cavity, leveraging gravitational forces to create mechanical space within the uterine cavity, thereby encouraging spontaneous cephalic version toward the pelvic inlet. Post-intervention clinical evaluation demonstrated excellent patient comprehension and adherence, with the patient correctly executing the posture independently and safely. The structured integration of fundamental biomedical principles and procedural clinical skills centered on patient safety effectively optimizes antenatal care outcomes and early malpresentation management in primary healthcare settings.