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Breech Presentation

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by

Richard Tilson

on 16 May 2011

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Transcript of Breech Presentation

Breech presentation Richard Tilson Prevalence Diagnosis Management External Cephalic Version C-section vs. Vaginal delivery Clinical
USS Definition Classification Presenting part = fetal buttocks Footling Flexed Extended Vaginal breech delivery 26 weeks - 40%
30 weeks - 20%
Term - 3% Risk Factors Uterine Fetal Fibroids
Congenital abnormalities
Uterine surgery Multiple gestation
Abnormality
Neuromuscular condition Amniotic Placental ECV 36-37 weeks Uncomfortable Effective in ~2/3 Easier in multiparous women Harder if overweight, fibroids Risks Abruption
PPROM
Cord accident
Haemorrhage
Fetal bradycardia Contraindications: Footling breech
Baby >3.5 or <2.5kg
Possible feto-pelvic disporportion
Hyperextenstion of fetal head Definition, aetiology, management and complications Oligohydramnios
Polyhydramnios Praevia Success more likely if: None of above
Multiparous
Positive mental attitude
Obstetric expertise Complications of Breech PPROM and preterm labour
Cord prolapse
Obstructed labour
Birth trauma
Asphyxia
Perinatal / Neonatal mortality (1%) References Obstetrics by Ten Teachers, Edited by Philip N Baker. London: Hodder Arnold, 2006 Patient UK article, http://www.patient.co.uk/doctor/Breech-Presentations.htm Hannah M.E., Hannah W.J., Hewson S.A., Hodnett E.D., Saigal S., Willan A.R., and Term Breech Trial Collaborative, 2000. Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. The Lancet, Volume 356, Issue 9239, 21 October 2000, Pages 1375-1383
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