Malpresentation

Question 1

What is malpresentation?

Answer 1

When the baby is not cephalic as birth approaches

Question 2

What is the most common type of malpresentation?

Answer 2

Breech presentation

Question 3

What is a complete breech?

Answer 3

Where the legs and hips are fully flexed

Question 4

What is an incomplete breech?

Answer 4

One leg fully flexed at the knee and hip, with one leg extended at the knee and flexed at the hip

Question 5

What is an extended breech?

Answer 5

Both legs extended at the knee and flexed at the hip

Question 6

What is a footling breech?

Answer 6

Leg extended with a foot presenting through the cervix

Question 7

What is the management of a breech presentation before 36 weeks?

Answer 7

Observation - many fetuses turn spontaneously

Question 8

What is the management of a breech presentation after 36 weeks?

Answer 8

External cephalic version can be performed:
- After 36 weeks for nulliparous women
- After 37 weeks for multiparous women

Question 9

What are the contraindications to ECV?

Answer 9

When c-section delivery is required
Antepartum haemorrhage in last 7 days
Abnormal CTG
Major uterine abnormality
Ruptured membranes
Multiple pregnancy

Question 10

What is the management of a breech baby if ECV has failed?

Answer 10

Planned LSCS or vaginal delivery

Question 11

How is ECV performed?

Answer 11

Tocolysis with SC terbutaline is given to relax the uterus, making it easier for baby to turn