BREECH PRESENTATION

  • Most common breech presentation is Left sacroanterior
  • Percentage of breech at term is 3 %
  • Fetal malformation , Uterine anomaly & Cornual implantation of placenta are associated with breech presentation at normal full term pregnancy
  • Prematurity is the commonest cause for breech presentation
  • 3 incidence rate of breech presentation at term
  • A 38 week pregnant primigravida with breech presentation is found to have cord prolapse. LEAST chances of cord prolapse are seen in Frank breech
  • Causes of breech presentation are Hydramnios,Septate uterus,Hydrocephalus, Placenta praevia & Pelvic contracture
  • Best method to deliver arms in breech is Lovset's method
  • The after coming head of breech chin to pubes is delivered by Manual rotation and extraction by Piper's forceps
  • Techniques of delivery of after coming head in breech presentation are 
  • Burns marshall technique
  • Mouriceau smellie met technique
  • Piper's forcep.
  • Cause of death in breech delivery are
  • Intracranial hemorrhage
  • Asphyxia
  • Atlanto axial dislocation
  • Breech presentation with hydrocephalus is managed by 
  • Cesarean section
  • Trans-abdominal decompression
  • PV decompression and Craniotomy of aftercoming head both
  • For delivery of the after- coming head in breech presentation Wrigely's forceps weeks - 5% and at term - 3%.is used
  • A case of 32 weeks of pregnancy with cornual placenta with breech presentation, treatment of choice is wait & watch
  • Fetal injury in breech extraction are Injury to lung
  • The pinard's manoeuvre is seen breech extraction
  • Assisted breech delivery is done for 
  • Extended breech
  • Complete breech
  • Weight of baby less than 2 kg and History of previous two successful breech delivè‹Ÿries both
  • The chief cause of perinatal mortality in term frank breech presentation is Intracranial hemorrhage
  • Recurrent breech presentation is seen In Congenital uterine anomaly
  • Breech presentation is mostly mistaken for Face presentation
  • Fetal injury in breech extraction are
  • Injury to liver
  • Intracranial hemorrhage
  • Injury to adrenal gland
  • In breech, engagement takes places earliest in frank
  • Ideal management of 37 weeks uncomplicated breech pregnancy is External cephalic version and trial of vaginal delivery.
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