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- 2. The definition of breech presentation is when the buttocks, foot or feet are presenting instead of
- 3. classifications Frank breech where the hips are flexed and legs extended Complete breech where the hips
- 5. Associations and Causes
- 6. Maternal factors Polyhydraminos Uterine anomalies (bicornuate, septate) Space occupying lesions (e.g fibroids) Placental abnormalities (praevia, cornual)
- 7. Fetal factors Prematurity Fetal anomalies (e.g neurological, hydrocephalus, anenecephaly) Multiple pregnancy Fetal death Short umbilical cord
- 8. The incidence of breech presentation decreases from about 20% at 28 weeks of gestation to 3–4%
- 9. What information should be given to women with breech presentation regarding mode of delivery?
- 10. Term Breech Trial 2000 trials with 2396 participant Caesarean delivery 1060/1169 (91%) of those women allocated
- 11. Perinatal or neonatal death(excluding fatal anomalies) or short-term neonatal morbidity was reduced with a policy of
- 12. After excluding ,perinatal mortality, neonatal mortality or serious neonatal morbidity with planned caesarean section compared with
- 13. adverse perinatal outcome was lowest with prelabour caesarean section and increased with caesarean section in labour
- 14. In the latter study, of the 2526 women with planned vaginal deliveries, 1796 delivered vaginally (71%)
- 15. death or neurodevelopmental delayat age 2 years, was similar between the two groups.
- 16. Summary of TBT lower rates of perinatal and neonatal death lower rates of short term neonatal
- 17. What factors affect the safety of vaginal breech delivery should be assessed carefully before selection for
- 18. unfavourable for vaginal breech birth ● other contraindications to vaginal birth (e.g. placenta praevia, compromised fetal
- 19. Intrapartum management should take place in a hospital with facilities for emergency caesarean section Labour induction
- 20. Epidural analgesia should not be routinely advised; women should have a choice of analgesia during breech
- 21. Continous electronic fetal heart rate monitoring should be offered to women with a breech presentation in
- 22. Caesarean section should be considered if there is delay in the descent of the breech at
- 23. Three types of vaginal breech deliveries Spontaneous breech delivery Assisted breech delivery Total breech extraction
- 24. Total breech extraction only with 2nd non vextex twin delivery procedure in which the infant's feet
- 25. ECV External cephalic version (ECV) is the transabdominal manual rotation of the fetus into a cephalic
- 27. contraindication to ECV preterm Multiple pregnancy significant third trimester bleeding IUGR, oligohydramnion PROM PIH nonreassuring foetal
- 28. Risk of ECV umbilical cord entanglement abruptio placenta premature rupture of the membranes (PROM) severe maternal
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