Breech Presentation Flashcards
What is breech presentation?
Breech presentation occurs when the fetus is positioned with the buttocks or feet closest to the cervix, rather than the head.
What are the types of breech presentation?
Types include frank breech (hips flexed, knees extended), complete breech (hips and knees flexed), and footling breech (one or both feet presenting).
What is the most common type of breech presentation?
The most common type is frank breech.
How common is breech presentation at term?
Breech presentation occurs in approximately 3-4% of pregnancies at term.
What are the risk factors for breech presentation?
Risk factors include prematurity, multiple pregnancy, uterine abnormalities, placenta praevia, polyhydramnios, and fetal anomalies.
How is breech presentation diagnosed?
Diagnosis is made through clinical examination (e.g., Leopold’s manoeuvres) and confirmed with ultrasound.
What are the clinical signs of breech presentation?
Signs include a palpable head in the fundus and absence of a head in the pelvis during abdominal palpation.
What is external cephalic version (ECV)?
external cephalic version (ECV) is a procedure to turn a breech fetus into a cephalic position by applying pressure on the maternal abdomen.
When is external cephalic version (ECV) typically performed?
external cephalic version (ECV) is usually performed between 36-37 weeks of gestation for nulliparous women and from 37 weeks for multiparous women.
What are the contraindications for external cephalic version (ECV)?
Contraindications include uterine abnormalities, placenta praevia, multiple pregnancy, ruptured membranes, and fetal distress.
What are the success rates for external cephalic version (ECV)?
Success rates are approximately 50-60%, with higher success in multiparous women.
What are the complications of external cephalic version (ECV)?
Complications include transient fetal heart rate abnormalities, uterine rupture, placental abruption, and preterm labour.
What are the delivery options for breech presentation?
Delivery options include planned caesarean section or vaginal breech delivery in selected cases.
What is the recommended mode of delivery for breech presentation at term?
Planned caesarean section is generally recommended for term breech presentations to reduce neonatal morbidity and mortality.
When is vaginal breech delivery considered safe?
Vaginal breech delivery may be considered if the fetus is a frank breech, there are no contraindications, and skilled personnel are available.
What are the risks of vaginal breech delivery?
Risks include cord prolapse, head entrapment, birth trauma, and hypoxia.
What is the role of ultrasound in breech presentation?
Ultrasound confirms the fetal presentation, estimates fetal weight, and excludes conditions like fetal anomalies or placenta praevia.
What is the importance of fetal weight estimation in breech presentation?
Estimation of fetal weight helps guide the choice of delivery mode, as macrosomia increases the risks of vaginal breech delivery.
What are the potential complications of breech presentation for the fetus?
Complications include birth trauma, cord prolapse, hypoxia, and increased perinatal morbidity and mortality.
What are the potential complications of breech presentation for the mother?
Maternal complications include increased risk of caesarean delivery, uterine rupture, and postpartum haemorrhage.
How is breech presentation managed in preterm labour?
Management depends on gestational age, fetal wellbeing, and maternal health, with a focus on safe delivery options.
What is cord prolapse, and how is it related to breech presentation?
Cord prolapse is when the umbilical cord descends through the cervix ahead of the presenting part, more common in footling breech.
How can breech presentation be prevented?
Prevention is not always possible, but addressing modifiable risk factors like polyhydramnios or uterine anomalies may reduce incidence.
What are the psychological impacts of breech presentation on pregnant women?
Women may experience anxiety about delivery mode and outcomes, requiring counselling and support.
What are the indications for an elective caesarean in breech presentation?
Indications include term breech, contraindications to vaginal delivery, and failed external cephalic version (ECV).
How should women with a previous breech delivery be managed in subsequent pregnancies?
Close monitoring of fetal presentation and timely external cephalic version (ECV) or delivery planning are recommended.
What is the role of antenatal counselling in breech presentation?
Counselling helps women understand their options, risks, and the potential need for external cephalic version (ECV) or caesarean delivery.
