L5: Malpresentation & Malposition (Breech) Flashcards
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Def of Breech Presentation
Malpresentation in which presenting part is podalic pole (buttocks + LLs) & denominator is sacrum.
Incidence of Breech Presentation
Positions of Breech Presentation
Common Breech Presentation positions
Types of Breech Presentation
Compare between Types of Breech Presentation in terms of:
- Incidence
- PP
- Hips
- Knees
- Figure
Best Breech Presentation & Why
Worst Breech Presentation & Why
Etiology of Breech Presentation
Etiology of Breech Presentation
- Power
Abdominal muscles laxity (allows free fetal movements).
Etiology of Breech Presentation
- Passage
- Bony pelvis: Contracted pelvis.
- Soft tissue passages: Uterine anomalies & fundal fibroid.
Etiology of Breech Presentation
- Passenger
Etiology of Breech Presentation
- Most Important Cause
Prematurity
Etiology of Breech Presentation
- Idiopathic
20% of cases
Mechanism of labor in Breech Presentation
- Delivery of Buttocks, LLs & Trunk
- Delivery of Shoulders & Legs
- Delivery of Aftercoming Head
Delivery of Buttocks, LLs & Trunk in Breech Presentation
Delivery of Shoulders & Arms in Breech Presentation
Delivery of Aftercoming Head in Breech Presentation
Delivery of Aftercoming Head in Breech Presentation
- Why is it more difficult than forhead?
- More difficult than delivery of forecoming head because longitudinal diameters of aftercoming head are less compressible & there is no time for moulding)
Delivery of Aftercoming Head in Breech Presentation
- Engagement
- Engaging longitudinal diameter of fetal head: Usually SOF (10 cm) & may be OF (11. 5 cm) due to deflexion.
- Diameter of engagement in pelvic inlet: Oblique diameter opposite to that traversed by buttocks & shoulders (perpendicular to each other).
Delivery of Aftercoming Head in Breech Presentation
- Internal Rotation