Breech Delivery | The University Of Western Ontario

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

333

Pages:

3
Author:

Kyuwon J.

Breech delivery ● Breech presentations ○ Fetal buttock (or sometimes feet) are first seen on pelvic inlet ■ Usually cephalic, vertex ○ Decrease gestation ■ Common for early pregnancy ● Roughly 3-4% ■ Higher risk on cord porlaspes and head entrapment ● Birth trauma and asphyxia ● Vaginal delivery ● Types ○ Frank breech ■ Most common ■ Hips flexed ■ Extension of knee ● Buttocks first ○ Complete breech ■ Hip flexed ■ Knees flexed ● Buttocks and feet ○ Footing breech ■ one/both feets are present first ■ Highest cord prolapse risk ○ Kneeling breech ■ Rare Footing + unstable breech are generally not suitable on vaginal birth since the cord prolapse + incompletion of dilation and head issue Rx ● Maternal and uterine ○ Uterine anomaly ■ Septate ■ Bicornuate ■ Fibroids ○ Placenta praevia ○ Low-lying placenta ○ Multiparity ■ Lax uterus ■ Previous breech ○ Pelvic mass ● Fetal ○ ○ ○ ○ ○ Prematurity Multiple gestation Oligohydramnios Polyhydramnios Fetal anomaly ■ CNS anomalies ■ Growth restriction ○ Short umbilical cord ■ Less common Dx ● Clinical ○ Fundal palpation ■ Hard round mass on fundus ⇒cephalic ■ Could be softer or irregular in pelvis ○ Ultra sound ■ Confirmation of type of breech ■ Fetal weight estimation ■ Placental location ■ Amniotic fluid assessments ■ Anomaly scanning ■ Consideration of vaginal breech ● Head flexion and extension ● Other eligibility criteria ○ Local protocol dependent