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DM2 Prep- Obstetrics > Breech + ECV > Flashcards

Breech + ECV Flashcards

1
Q

Most common breech

A

Frank

65%

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2
Q

Least common breech

A

Complete

5-10%

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3
Q

What percentage of babies are breech at 28 weeks

A

20%

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4
Q

What percentage are breech at 32 weeks

A

16%

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5
Q

What percentage are breech at term

A

3-4%

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6
Q

How many breech at 36 weeks convert to Cephalic by term

A

8%

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7
Q

What percentage of breech vaginal births are converted to LSCS

A

40%

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8
Q

Perinatal morbidity and mortality for planned lscs due to breech

A

0.5 : 1000

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9
Q

Perinatal morbidity and mortality planned vaginal breech delivery

A

2: 1000

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10
Q

What percentage of ECV successful

A

50%

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11
Q

How many successful ECV revert to breech by term

A

3%

Increased in multigravidas

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12
Q

Percentage success of ECV in
a) nulliparous
B) multiparous

A

A) 40%
B) 60%

Overall 50%

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13
Q

What gestational age to attempt ECV
a) nulliparous
B) multiparous

A

A) 36 weeks
B) 37 weeks

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14
Q

Incidence of footling breech

A

10-40%

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15
Q

Unfavorable breech factors (7)

A
  • footling or kneeling
  • > 3.8kg
  • <2kg
  • hyperextended fetal neck
  • contraindications to vaginal birth
  • lack of trained personnel
  • previous section (relative contraindication)
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16
Q

Risk of cord prolapse with footling breech

17
Q

Risk of cord prolapse with frank breech

18
Q

Risk of cord prolapse with cephalic presentation

19
Q

Risk of cord prolapse with complete breech

20
Q

Perinatal mortality reduction with planned lscs (elearning)

A

67% reduction

21
Q

Positive predictors of ecv success (8)

A
  • multiparty
  • non engaged breech
  • maternal weight <65kg
  • tocolysis
  • palpable fetal head
  • posterior placenta
  • complete breech
  • afi >10
22
Q

What tocolytic is recommended for use in ECV

A

Betamimetics

Salbutamol 250mcg in 25ml NS
Terbutaline 250mcg sc

23
Q

What are the negative effects of betamimetics

A
  • palpitations
  • tachycardia
  • flushing
  • tremor
  • nausea
24
Q

What are medical contraindications to betamimetics

A
  • cardiac disease
  • hypertension
  • diabetes
25
Q

Contraindications to ecv(5)

A
  • placenta praevia
  • multiple pregnancy
  • rhesus isoimmunization
  • current or recent APH
  • ruptured membranes
26
Q

Risk of emergency section in 24hours

27
Q

What precautions should be taken for fetal safety with ECV

A
  • performance in facility for monitoring fetus and surgical delivery
  • standard preoperative investigations are NOT required
  • FMH testing post procedure if RH D neg
28
Q

How many attempts and time duration is recommended for ECV

A
  • 4 attempts
  • 10minutes total

DM2 Prep- Obstetrics (23 decks)

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