Breech-csv Flashcards
A 32 y/o (2002) requested for an external cephalic version at 34-36 wks aog after it was diagnosed with utz as complete breech she is afraid that most severe frequent complication of vaginal breech delivery might happen to her baby which is
a. Head entrapment
b. Cord prolapse
c. Spinal cord injury
d. Abruptio placenta
b. Cord prolapse
pg 542
Compared with cephalic presentation, umbilical cord prolapse is more frequent with breech fetuses
Based on nursery statistics received, the most major neonatal morbidity and mortality with breech presentation is:
a. Birth trauma
b. IUGR
c. Cord prolapse
d. Cerebral palsy
c. Cord prolapse
29 y/o G5P4 (4004) is in latent phase of labor. Absolute contraindication for vaginal breech delivery:
a. Prolong missed abortion
b. Footling breech
c. Hyperflexion of fetal head
d. Prolonged latent phase of labor
b. Footling breech
Table 28-1. Factors favoring Cesarean Delivery of the Breech Fetus
. Lack of operator experience
. Patient request for cesarean delivery
. Large fetus >3800 to 4000g
. Apparently healthy and viable preterm fetus either with active labor or with indicated delivery
. Severe fetal-growth restriction
. Fetal anomaly incompatible with birth trauma
. Incomplete or footling breech presentation
. Hyperextended head
. Pelvic contraction or unfavorable pelvic shape determined clinically or with pelvimetry
. Prior cesarean delivery
A 22 y/o G1P0, 37 weeks AOG, in breech position and is advised External Cephalic Version. She should be told that:
a. She should be offered General anesthesia
b. The procedure can be done with oligohydramnios
c. Tocolysis will improve the result of external version
d. Engagement of the presenting part is not considered a contraindication to version
d. Engagement of the presenting part is not considered a contraindication to version
Causes of breech, except:
a. Premature
b. Multiple pregnancy
c. Placenta previa totalis
d. Subserous fundal fibroid
d. Subserous fundal fibroid
pg 540 Risks include . Early gestational age . Extremes of amniotic fluid volume . Multifetal gestation . Hydrocephaly . Anencephaly . Structural uterine abnormalities . Placenta previa . Pelvic tumors . Prior breech delivery
G3P2 (2002), term, frank breech in labor, intrauterine fetal death, G1 delivered vaginally, G2 delivered by caesarean section due to fetal distress, mgt?
a. Vaginal delivery
b. CS
c. Either A or B
b. CS
A G5P4 (4004), term, footling breech in labor, with ruptured bag of membranes
a. Vaginal delivery
b. CS
c. Either A or B
b. CS
Table 28-1. Factors favoring Cesarean Delivery of the Breech Fetus
. Lack of operator experience
. Patient request for cesarean delivery
. Large fetus >3800 to 4000g
. Apparently healthy and viable preterm fetus either with active labor or with indicated delivery
. Severe fetal-growth restriction
. Fetal anomaly incompatible with birth trauma
. Incomplete or footling breech presentation
. Hyperextended head
. Pelvic contraction or unfavorable pelvic shape determined clinically or with pelvimetry
. Prior cesarean delivery
G4P2 (2012), 22 weeks, franks breech, in labor
a. Vaginal delivery
b. CS
c. Either A or B
a. Vaginal delivery
541
periviable fetuses, 20-<26 weeks, do no support routine cesarean delivery to improve mortality
A G1P0, term, frank breech in labor
a. Vaginal delivery
b. CS
c. Either A or B
c. Either A or B
One knee lie below breech
a. Complete breech
b. Frank breech
c. Incomplete breech
d. A and B
c. Incomplete breech
Lower extremities are flexed
a. Complete breech
b. Frank breech
c. Incomplete breech
d. A and B
d. A and B (Complete and Frank)
Both hips are flexed and one or both knees are also flexed
a. Complete breech
b. Frank breech
c. Incomplete breech
d. A and B
a. Complete breech
The lower extremities are extended at the knees
a. Complete breech
b. Frank breech
c. Incomplete breech
d. A and B
b. Frank breech
Double footling breech
a. Complete breech
b. Frank breech
c. Incomplete breech
d. A and B
c. Incomplete breech
What do you call the type of vaginal breech where an infant was delivered without assurance as far as the umbilicus, and the reminder of the body is manually assisted by the obstetrician?
a. Spontaneous breech delivery
b. Assisted breech delivery / partial breech extraction
c. Total breech extraction
d. A and B only
b. Assisted breech delivery / partial breech extraction
fetus is expelled entirely spontaneously without any traction or manipulation other than support of the newborn
a. Spontaneous breech delivery
b. Assisted breech delivery / partial breech extraction
c. Total breech extraction
a. Spontaneous breech delivery
the fetus is delivered spontaneously as far as the umbilicus, but the remainder of the body is extracted or delivered with operator with operator traction and assisted maneuvers, with or without maternal expulsive efforts
a. Spontaneous breech delivery
b. Assisted breech delivery / partial breech extraction
c. Total breech extraction
b. Assisted breech delivery / partial breech extraction
the entire body of the fetus is extracted by the obstetrician.
a. Spontaneous breech delivery
b. Assisted breech delivery / partial breech extraction
c. Total breech extraction
c. Total breech extraction
All are risk factors for breech presentation, EXCEPT:
a. Smoking
b. Hydrocephalus
c. Increased maternal age
d. Pelvic tumor
c. Increased maternal age
Which of the statements is INCORRECT?
a. Breech presentation is more common in babies.
b. All women with a breech presentation should be offered external cephalic version at 37-38 weeks.
c. Breech presentation is associated with a higher perinatal mortality regardless of the mode of delivery.
d. CS should be offered to all women with twins where the presentation is cephalic in the first twin and breech in the second twin.
c. Breech presentation is associated with a higher perinatal mortality regardless of the mode of delivery.
Refers to the relationship of an arbitrarily chosen portion of the presenting part to the right or left side of the birth canal.
a. Fetal lie
b. Fetal presentation
c. Fetal position
d. Fetal attitude
c. Fetal position
the relation of the fetal long axis to that of the mother and is either longitudinal or transverse
a. Fetal lie
b. Fetal presentation
c. Fetal position
d. Fetal attitude
a. Fetal lie
the presenting part is that portion of the fetal body that is either foremost within the birth canal or in closest proximity to it
a. Fetal lie
b. Fetal presentation
c. Fetal position
d. Fetal attitude
b. Fetal presentation
characteristic posture assumed by the fetus in the latter months of pregnancy
a. Fetal lie
b. Fetal presentation
c. Fetal position
d. Fetal attitude
d. Fetal attitude
What are the two options that can be felt with Leopold’s Maneuver 1? What do they describe? What can be told from the following?
a. Fetal lie
b. Fetal presentation
c. Fetal position
d. Fetal attitude
pg 424
Breech - large, nodular mass
Head - hard and round and more moveable
a. Fetal lie
What are the two options that can be felt with Leopold’s Maneuver 2? What do they describe? What can be told from the following?
a. Fetal lie
b. Fetal presentation
c. Fetal position
d. Fetal attitude
pg 424
Back - hard, resistant structure
Fetal extremities - small, irregular mobile parts
c. Fetal position
Which maneuver is normally used during breech delivery to deliver head?
a. Pinard�s maneuver
b. Mauriceau maneuver
c. Loveset�s maneuver
d. Leopold�s maneuver
e. Modified Prague maneuver
f. Zavanelli maneuver
b. Mauriceau maneuver
pg 546
Index and middle finger of one hand are applied over the maxilla, to flex the head, while the fetal body rests on the palm of the same hand and forearm
What maneuver is used when the breech is born with back posterior?
a. Pinard�s maneuver
b. Mauriceau maneuver
c. Loveset�s maneuver
d. Leopold�s maneuver
e. Modified Prague maneuver
f. Zavanelli maneuver
e. Modified Prague maneuver
What maneuver is used in frank breech?
a. Pinard�s maneuver
b. Mauriceau maneuver
c. Loveset�s maneuver
d. Leopold�s maneuver
e. Modified Prague maneuver
f. Zavanelli maneuver
a. Pinard’s maneuver
What maneuver is used for nuchal arm?
a. Pinard�s maneuver
b. Mauriceau maneuver
c. Loveset�s maneuver
d. Leopold�s maneuver
e. Modified Prague maneuver
f. Zavanelli maneuver
c. Loveset’s maneuver
What maneuver is used for head entrapment?
a. Pinard�s maneuver
b. Mauriceau maneuver
c. Loveset�s maneuver
d. Leopold�s maneuver
e. Modified Prague maneuver
f. Zavanelli maneuver
f. Zavanelli maneuver
The forceps specifically designed for the delivery of the aftercoming head in the breech birth.
a. Simpson forceps
b. Piper forceps
c. Ovum forceps
d. Uterine forceps
b. Piper forceps
