Fetal Malpresentation Flashcards
1
Q
Types of Fetal Malpresentation
A
- Breech Presentation
- Face Presentation
- Brow Presentation
- Compound + Shoulder (rare)
2
Q
Types of Breech Presentation
A
- Frank breech (65%)
- Complete breech (25%)
- Incomplete (or footling) breech (10%)
3
Q
Etiology of Breech Presentation
A
- Prematurity (the most common cause of breech)
- Hydraminos (poly or oligo)
- Multiple gestation
- Placenta previa
- Fetal anomalies (hydrocephalus, anencephaly)
- Uterine anomalies (bicornuate uterus)
4
Q
Complications of Breech Presentation
A
Inherent problems in the fetus:
- Prematurity
- Congenital anomalies
Complications due to breech delivery:
- Cord prolapse
- Birth asphyxia
- Entrapment of aftercoming head
- Birth trauma
5
Q
External Cephalic Version (ECV)
A
- Conversion of noncephalic presentation to cephalic presentation by abdominal manipulation is known as ECV
- Performed at 36 or 37 weeks
- US is mandatory before ECV
6
Q
ECV Contraindications
A
Absolute:
- Placenta previa
- Multifetal pregnancy
- Major uterine anomalies
Relative:
- Previous c-section
- Fetal growth restriction
7
Q
ECV Predictors of Success
A
- Frank or complete breech
- Normal amniotic fluid volume
- Multiparous women
8
Q
Criteria for Vaginal Delivery of a Breech Presentation
A
- Frank or complete breech
- Gestational age at least 36 weeks
- Estimated fetal weight 2500-3500 g
- Fetal head must be flexed (no hyperextension)
- Maternal pelvis adequately large
- No other maternal or fetal indication for cesarean
- Experienced obstetrician & neonatologist
9
Q
Indications for C-Section
A
- Incomplete (footling) breech
- Prematurity
- Estimated fetal weight > 3800 g
- Hyperextended fetal head
