Chapter 28 (Breech Delivery)

Question 1

Type of breech in wherein the lower extremities are flexed at the hips and extended at the knees, and thus the feet lie close to the head

Answer 1

FRANK BREECH

Question 2

Type of breech wherein both hips ate flexed and one or both knees are also flexed

Answer 2

COMPLETE BREECH

Question 3

Type of incomplete breech wherein one or both feet are below the breech

Answer 3

FOOTLING BREECH

Question 4

Mode of delivery for breech fetuses with hyperextended neck (Stargazing fetus)

Answer 4

CESAREAN DELIVERY

Question 5

Risk factors predisposing to breech presentation except:
A. Multifetal gestation
B. Hydrocephaly
C. Anencephaly
D. Structural uterine anomalies
E. Placenta previa
F. Pelvic tumors
G. Prior breech delivery
H. Extremes of amniotic fluid
I. None of the ahove

Answer 5

I. NONE OF THE ABOVE

Question 6

Following one breech delivery, the recurrence rate for a second breech presentation was __% and for a subsequent third breech is __%

Answer 6

10%

28%

Question 7

The fetal _______ is used to establish fetal position

Answer 7

SACRUM

Question 8

True or False

Fetal weight is more important than gestational age in considering whether to do vaginal breech delivery or not

Answer 8

TRUE

Question 9

Vaginal breech delivery is reasonable when the estimated fetal weight is

Answer 9

> 2500 grams

Question 10

Factors favoring cesarean delivery of the breech fetus include the following except:

A. Lack of operator experience
B. Maternal request for CS
C. EFW  > 3800 grams
D. Severe fetal growth restriction
E. NOTA

Answer 10

E. NOTA

Question 11

Factors favoring cesarean delivery of the breech fetus include the following except:

A. Fetal anomaly incompatible with vaginal delivery
B. Prior perinatal death or neonatal death trauma
C. Incomplete or footling breech presentation
D. Hyperextended head
E. NOTA

Answer 11

E. NOTA

Question 12

Vaginal delivery method by which the fetus is expelled entirely without any traction or manipulation other than support of the newborn

Answer 12

SPONTANEOUS BREECH DELIVERY

Question 13

Vaginal delivery method by which the fetus is delivered spontaneously as far as the umbilicus, but the remainder of the body is delivered by the provider

Answer 13

PARTIAL BREECH EXTRACTION

Question 14

Vaginal delivery method by which the fetus’s entire body is extracted by the provider

Answer 14

TOTAL BREECH EXTRACTION

Question 15

Imaging technique which provides the best confirmation on type pr breech, and degree of neck flexion or extension

Answer 15

SONOGRAPHY

Question 16

Although variable, some suggests specific measurements to permit a planned vaginal delivery

Inlet AP diameter: >=__ cm
Inlet transverse diameter: >=__ cm
Midpelvic interspinous distance: >=__ cm

Answer 16

Inlet AP diameter: >=10.5 cm
Inlet transverse diameter: >= 12.0 cm
Midpelvic interspinous distance: >=10.0cm

Question 17

Cardinal movements with breech delivery

Answer 17

Engagement
Descent
Internal rotation
Flexion
External rotation
Expulsion

E-D-Ir-F-Er-E

Question 18

Episiotomy preferred for vaginal breech delivery

Answer 18

MEDIOLATERAL

Question 19

Maneuvre performed wherein the index and middle finger of one hand are applied over the maxilla, to flex the head, while the fetal bldy rests on the palm of the same hand. Two fingers of the other had are placed over the fetal neck and grasp the shoulders

Answer 19

MAURICEAU MANEUVER

Question 20

Specialized forceps for the delivery of the aftercoming head

Answer 20

PIPER FORCEPS

Question 21

Maneuver done in which two fingers of one hand grasp the shoulders of the back down fetus from below while the other hand draws the feet up and over the maternal abdomen

Answer 21

MODIFIED PRAGUE MANEUVER

Question 22

Incision in the cervix in cases of head entrapment during vaginal breech delivery

Answer 22

Dührssen incision

Question 23

Dührssen incision is done at:

Answer 23

2 o’clock

then

10 o’clock

then

6 o’clock (infrequently)

Question 24

Symphisiotomy widens the symphysis pubis by how many centimeters?

Answer 24

2.5 cm

Question 25

Maneuver:
• After the arms are delivered, the infant is grasped by the hips and lifted with two hands toward the mother’s stomach, without any traction, the neck pivoting around the symphysis.
• Having an assistant apply suprapubic pressure facilitates delivery of the aftercoming head.

Answer 25

Bracht’s maneuver

Question 26

Maneuver
Hold the baby by the hips and turn half a circle, keeping the back uppermost and applying downward traction at the same time, so that the arm that was posterior becomes anterior and can be delivered under the pubic arch.
Assist delivery of the arm by placing one or two fingers on the upper part of the arm. Draw the arm down over the chest as the elbow is flexed, with the hand sweeping over the face.
To deliver the second arm, turn the baby back half a circle, keeping the back uppermost and applying downward traction, and deliver the second arm in the same way under the pubic arch.

Answer 26

Loveset Maneuver

Question 27

Breech decomposition is accomplished by this maneuver. It aids in bringing the fetal feet within reach of the operator. Two fingers are carried up along one extremity to the knee to push it away from the midline. Spontaneous flexion usually follows and the foot of the fetus is felt to impinge on the back of the hand. The fetal foot then may be grasped and brought down.

Answer 27

Pinard maneuver