Breech presentation Flashcards
(11 cards)
risk factors?
- uterine malformation, fiborids
- placenta praevia
- polyhydraminos or oligohydraminos
- fetal abnormality
- prematurity
What is breech presentation?
Where the presenting part of the fetus is the legs & bottom which is opposed to cephalic presentation (head)
What is complete breech?
Where legs are fully flexed at hips & knees
What is incomplete breech?
One leg flexed at the hip & extended at the knee
What is extended/frank breech?
Both legs flexed at hip and extended at knee
(most common presentation)
What is footling breech?
A foot is presenting through the cervix, with leg extended
What is the management of breech?
- Breech before 36 weeks often turn spontaneously so no intervention required
- External cephalic version can be used at term (37 weeks) to attempt to turn fetus
- If ECV fails women are given the choice between vaginal delivery and elective caesarean
What are the chances of requiring an emergency C section when vaginal birth is attempted?
40%
What is ECV?
A technique used to attempt to turn a fetus from breech to cephalic position by putting pressure on the abdomen which is about 50% successful
When is ECV attempted?
After 36 weeks for nulliparous women - women who have previously not given birth
After 37 weeks in women that have given birth previously
What is given before ECV?
Tocolysis (subcut terbutaline) to relax the uterus and reduce the contractility of myometrium
