Malpresentations Flashcards
What is frank breech?
where the babies hips are flexed and the legs are extended (ankles by ears or pike position)
What is complete breech?
where the babies hips and knees are flexed and the feet are not below the level of the buttocks (cross-legged)
What is footling breech?
where one or both of babies feet are presenting with extension at the hips and knees
What is kneeling breech?
where one or both hips are extended with flexion at the knees so that the knee is the presenting part
What are the five types of malpresentation?
- brow
- face
- shoulder
- breech
- cord
When will face presentation necessitate surgical birth?
When the baby is presenting mento-posterior, which means that fetal back is anterior
mento-anterior is fine for vaginal birth
What proportion of babies are in shoulder presentation in labour?
1:250
What proportion of babies are in brow presentation in labour?
1:1000
What proportion of babies are in face presentation in labour?
1:500
What are the two types of incomplete breech?
- footling
- kneeling
From 29-32 weeks what percentage of babies present in breech position?
around 15%
At 35 weeks what is the chance that a breech baby will flip to cephalic?
25%
What percentage of babies remain in breech position at 36 weeks?
3-4%
What midwifery care should be offered for women with breech babies at 36 weeks?
- offer ECV
- discussions about LUSCS or planned vaginal breech birth
What 6 maternal factors are associated with a higher prevalence of breech presentation?
- polyhydraminos
- uterine anomalies (bicornate, septate)
- fibroids
- placental abnormalities (e.g. praevia)
- contracted (smaller-than-usual) maternal pelvis
- multiparity (particularly grand multiparity)
