Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mode of delivery > Breech > Flashcards

Breech Flashcards

1
Q

What is the incidence of breech in singletons at term?

A

3-4%

More common in nullips and in preterm deliveries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the contra-indications to vaginal breech delivery?

A

F - Fetal growth restriction or macrosomia
F - Fetal anomaly incompatible with vaginal breech delivery
A - Any presentation other than frank or complete breech
C - Cord presentation
C - Clinically inadequate maternal pelvis
E - Extension of the fetal head

+ Evidence of antenatal fetal compromise (RCOG GTG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the ideal setting for a planned vaginal breech delivery?

A
  1. Can provide CEFM in labour
  2. Immediate availability of Caesarean section facilities
  3. Availability of suitably experienced obstetrician to manage the delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is IOL recommended for breech deliveries?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is augmentation (with Synto, for slow progress) recommended for vaginal breech deliveries

A

Only in the context of reduced contraction frequency in the presence of regional anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What position is appropriate for vaginal breech birth?

A

Semi-recumbent or all-four position

Should take into account the wishes of the woman AND the practitioner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the perinatal mortality of planned vaginal breech delivery compared to planned CS for breech?

A

2/1000 vs 0.5/1000

(1/1000 for planned Cephalic birth)

Reasons for difference

  1. Avoidance of stillbirth after 39/40
  2. Avoidance of intrapartum risks
  3. Avoidance of risks of vaginal breech birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is moxibustion?

A

A traditional Chinese medicine therapy using Mona (made from dried mugwort)
Has been used from 32/40 to promote spontaneous version from breech to Cephalic presentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What gestation should ECVs occur?

A

From 37/40
From 36/40 for nullips (but not multiple, as spontaneous version is more common)

Gestation at term does not appear to affect success rates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In women having ECVs, what is the rate of serious adverse outcomes?

A

1: 200 will require EmCS for serious adverse outcome such as
- placental abruption
- cord prolapse
- acute fetal compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

In women having ECVs, what is the rate of minor complications?

A

4.3%

Transient CTG abnormalities, rupture of membranes, small APH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the success rate of ECV in nullips?

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the success rate of ECV in multips?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the rate of spontaneous version to breech after successful ECV?

A

3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the rate of spontaneous version from breech to Cephalic at term in primips after 36/40?

A

8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What factors increase the success rate of ECV?

A 
P - Palpable fetal head
U - Use of tocolytics
M -Multiparity
P - Posterior placenta
M - Maternal weight <65kg
A - AFI > 10
N - Non-engagement of the breech
C - Complete breech position
17
Q 
Which is the best tocolytic for ECV?
Name, class and dose
A

Betamimetics
Terbutaline
250mcg subcutaneous

18
Q

What are the contra-indications for terbutaline?

A

Significant cardiac disease
Hypertension
Medicated with b-blockers

19
Q

What are the side effects of terbutaline?

A 
Maternal palpitations
Tachycardia
Flushing
Tremor
Occasional nausea
20
Q

Should regional anaesthesia be used for ECV?

A

Not routinely

But can be used for women unable to tolerate the procedure

21
Q

Can ECV be used in Unstable Lie?

What are the risks of it?

A

Yes, in the course of stabilising IOL, only if IOL if indicated

Risks
Cord prolapse, transverse lie in labour, abnormal CTG

22
Q

What are the absolute contra-indications to ECV?

A

A - Anterpartum haemorrhage within the last 7 days
M - Major uterine anomaly
W - Where caesarean delivery is required (for another indication)
A - Abnormal CTG
R - Ruptured membranes
M - Multiple pregnancy

23
Q

Tactile stimulation of the breech fetus may result in….

A

Reflex extension of the arms or head

Should be minimised

24
Q

What are the indications for intervention in a vaginal breech birth
(When should you not be Hands off)

A

Poor tone, extended arms or an extended neck

More than 5 minutes from delivery of buttocks to head
More than 3 minutes from delivery of umbilicus to head

25
Q

What is the effect of planned vaginal breech delivery on perinatal morbidity?

A

Increased risk of low APGAR scores and serious SHORT-term consequences

But has not been shown to increase the risk of LONG term morbidity

26
Q

With planned vaginal breech birth, what is the rate of EmCS?

A

40%

Mode of delivery (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions