52. Breech extraction delivery.

Question 1

when is breech extraction performed ?

Answer 1

indications are - delivery of the second twin after internal podalic version

cord prolapse

or prolonged second stage of labour

fetal distress

Question 2

describe complete breech extraction?

Answer 2

it is done under general anesthesia

empty bladder through ureter cathterisation

a hand is introduced though the vagina do not rupture the membranes right away they will be ruptured on their own accord when the foot is pulled down or artificially wen the foot is down

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for complete breech

both fetal feet are grasped , with a finger lying between the feet

the feet are brought towards the introitus with gentle traction

if difficult they one foot drawn into the vagina but not through introits
then the other feet is brought down in similar fashion

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for frank breech - use pinard manuever - done best at time when membrane ruptured

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apply
downwards gentle traction until the anterioir hip is delivered

then have gradual upward traction to deliver the posterioir hip

Question 3

what re the complications of breech extraction ?

Answer 3

rarely done because birth injury to mother and fetus

The head of the second twin may get entrapped if the cervix is not fully dilated or if the second twin is significantly larger than the first twin

The baby’s hip socket and thigh bone may get separated during the delivery.

PPH