Breech Presentation Flashcards
What is this defined as?
What are its types?
➊ When the presenting (lowest) part of the foetus is the legs and bottom, instead of the head.
➋ * Complete breech - Both legs are fully flexed at the hips and knees
* Incomplete breech - One leg flexed at the hip and extended at the knee
* Extended breech (aka Frank breech) - Both legs flexed at the hip and extended at the knee
* Footling breech - Foot is presenting through the cervix with the leg extended
How is it managed?
Most babies that are breech turn spontaneously by 36 wks, so no intervention is needed. If this hasn’t happened, an External cephalic version (ECV) will be offered.
When ECV fails, woman are given the choice of a vaginal delivery or elective c-section.
N.B. Overall, vaginal birth is safer for the mother, and caesarean section is safer for the baby.
External Cephalic Version:
How successful is it?
When is it carried out?
What is given during the procedure?
➊ 50% success rate
➋ * 36 wks if primiparous
* 37-39 wks if multiparous
➌ * Tocolysis w/**Terbutaline ** to relax the uterus before the procedure. It reduces the contractility of the myometrium, making it easier for the baby to turn.
* Anti-D prophylaxis for RhD -ve women
