UW external cephalic version Flashcards
UW table. definition. decr. risk for what?
manual rotation of fetus to cephalic presentation
Decreases S/C delivery rate
UW table. indications?2
BREECH/TRANSVERSE presentation
>=37 weeks
UW table. what weeks?
> =37 weeks
UW table. absolute contraindications?
Contraindications to vaginal delivery:
prior classical cesarean delivery
prior extensive uterine myomectomy
placenta previa
UW table. complications? 3
abruption placentae
intrauterine fetal demise
emergency delivery
Breech presentation risk factors?
prematurity, multiparity, multiple gestation, uterine anomalies (eg, septate uterus), leiomyomas, placenta previa, and some fetal anomalies (eg, hydrocephaly).
Breech how Dx?
ultrasound
Examination findings consistent with a breech fetus include?
subcostal pain or a palpation of a hard mass near the uterine fundus (due to the fetal head) or lack of a fetal presenting part on digital cervical examination.
Patients with breech presentation and no contraindications to vaginal delivery ==>?
offered external cephalic version
If the fetus is successfully rotated to cephalic presentation =>?
patients can attempt a vaginal delivery
ECV has a risk of prelabor rupture of membranes, abruptio placentae, and preterm labor that may necessitate delivery; therefore, the procedure is performed at ≥37 weeks gestation to decrease the risks associated with premature delivery.
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Vaginal delivery may be appropriate for select patients spontaneously laboring with a fetus ……what position?
in frank or complete breech presentation
vaginal delivery is contraindicated in patients with what breech presentation?
footling or incomplete breech presentation
what if procedure is unsuccessful?
scheduled cesarean delivery
what if patient want vaginal delivery?
ECV should be attempted;
TRANSVERSE LIE. By term (ie, ≥37 weeks gestation), the majority of fetuses will have spontaneously rotated into a longitudinal lie (ie, fetal spine is parallel to the long axis of the uterus) and cephalic presentation as this prepares the fetus for delivery and is the most effective way to occupy the intrauterine cavity.
Therefore, patients with transverse lie and malpresentation at preterm gestations are managed expectantly with an ultrasound at term to evaluate fetal presentation.
previous classical cesarean delivery (as in this patient) is a contraindication to ….?
vaginal delivery
vertical (classic) S/c - no vaginal delivery
horizontal - galima daryt vaginal delivery
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can we do ECV in patients with Hx of vertical Sc?
ECV is not typically offered, and a repeat cesarean delivery should be recommended between 36-37 weeks gestation to decrease the risk of spontaneous labor and subsequent neonatal and maternal complications.
