ECV and breech Flashcards
1
Q
How common is breech presentation?
A
3-4%
2
Q
RF for breech
A
Uterine abnormalities- bicornuate etc
Congenital abnormalities
P0
3
Q
Perinatal mortality risks in breech vs ceph vs CS
A
CS: 0.5/1000
Ceph: 1/1000
Breech: 2/1000
4
Q
Success rate of ECV?
A
50%
5
Q
Good predictors for ECV
A
Non-engagement of fetal head
Multiparity
Tocolysis
Maternal wt <65kg
6
Q
Contraindications for ECV
A
Prev CS (1 CS not at greater risk)
Multiple preg
Fetal concerns
Bleeding
SROM/Oligo
Placental concerns ie praevia
Do not use tocolysis if- cardiac problems or HTN
7
Q
Timing for ECV
A
37 weeks onward, 36 weeks for P0
8
Q
No. of attempts
A
4 in maximum of 10min
9
Q
High risk factors for vaginal breech
A
- Hyperextended neck on USS
- High fetal wt >3.8kg
- Low fetal wt <10th centile
- Footling breech
- Fetal compromise
10
Q
Advised for birth
A
- Dont augment
- Can consider synto n 2nd stage
- Hospital birth
- CTG- does not necessarily improve outcomes
- 40% risk of CS
11
Q
Risk of vaginal breech birth
A
- Head entrapment
- Incision to the cervix
- Extensions/ complex CS if needed
