Breech presentation Flashcards

1
Q

Types of breech

A

Complete
Incomplete
Extended
Footiling

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2
Q

What is complete breech

A

legs fully flexed at hips and knees

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3
Q

What is incomplete breech

A

One leg flexed at hip, one extended at knee

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4
Q

What is extended breech

A

Frank beech - both legs flexed at hip and extended at knee
Folded in half

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5
Q

Pubic symphysis dysfunction

A

Moving in pregnancy is lose -> significatn pain in pregnancy

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6
Q

Footling breech

A

Foot presenting through cervix with leg extended

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7
Q

When is breech managed

A

After 36 weeks

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8
Q

When is breech managed

A

After 36 weeks

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9
Q

First step in managing breech

A

External cephalic version (ECV)
used at 37 weesk

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10
Q

Options if ECV fails for breech

A

Vaginal delivery - safre for mother
Elective C section = safer for baby

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11
Q

Chance of emergency C section when try vaginal delivery with breach

A

40%

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12
Q

When is a C section required in breech

A

If twins and first twin is breech

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13
Q

How successful is ECV

A

50%

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14
Q

WHen is ECV used in nullipaorus vs multiparous women

A

After 36 weeks - nulliparous
After 37 weeks - given birth naturally

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15
Q

What is given before ECV

A

Tocolysis with SC terbutaline
Anti D prophylaxis if rhesus negative mother

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16
Q

Complete contraindications for vaginal delivery

A

Transverse lie
Contracted pelvis
Placenta preiva

17
Q

What is terbutaline and what does it do?

A

Beta agonsit
Reduces contractility of myometrium - easier for baby to turn

18
Q

What breech is safer

A

Extended breech -bum presenting
Flexed breech - incomplete - with feet presentation -
head extended so can’t fit through

19
Q

Why is it singificant rhesus status of mother in ECV?

A

If rhesus negative need to give anti-D prophylaxis

20
Q

What test is performed to quantify foetal and maternal blood amount mixed?

A

Kleihauer test

21
Q

How determine dose of anti D required before ECV in rhesus negative women

A

Kleihauer test - measure how much foetal and maternal blood mixing

22
Q

Why are small babies high risk labour

A

Contraction of labour reduced blood supply ot lpacenta and therefore baby