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    Breech

    Uploaded by

    Araceli Ecot Calunod
    breech2

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Breech

    Uploaded by

    Araceli Ecot Calunod
    22 views1 page
    breech2

    Original Title

    38187010-Breech

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    © Attribution Non-Commercial (BY-NC)

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    breech2

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    22 views1 page

    Breech

    Uploaded by

    Araceli Ecot Calunod
    breech2

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Management of Breech Presentation

    Clinical

    Abdominal examination: the head of the fetus is in the upper part of the uterus. Auscultation locates the fetal heart at a higher location than expected with a vertex presentation. Vaginal examination: the buttocks and/or feet are felt. Thick, dark meconium is normal when membranes rupture in the second stage of labour.

    X-ray of the pelvis to confirm presentation is to be avoided.

    Ultra sound

    conform the presenting part localizatiion of placenta exclusion of abnormalities,etc.

    THE DIAGNOSIS OF BREECH CONFIRMED


    prior to 36 completed Wait till 36 completed weeks

    External cephalic version not recommended1

    Informed Decision Making is Essential

    36 weeks
    uncomplicated breech at 37 to 40 weeks

    Documentation Mandatory

    May be offered tocolysis (with beta mimetic drugs) to increase the success of external cephalic version (ECV) Electronic foetal monitoring (EFM)

    external cephalic version (ECV) uncomplicated ( no extended or flexed leg) breech presentation at term complicated (extended or flexed leg) breech presentation at term

    Unsuccessful

    38 weeks

    Delivery
    No indication for L.S.C.S

    Relative indications for Caesarean section


    Intrauterine growth restriction. Previous uterine scar Hyperextension of the fetal head (Star gazer) -When the head cannot be flexed Small pelvis or suspicious pelvic adequacy Footling presentation Gestation less than 34 weeks

    Absolute indications for Caesarean section


    Feto-pelvic disproportion -When the fetal weight is estimated to be 3.8 kg or more Major degree placenta praevia Pelvic or uterine tumors preventing descent of presenting part. Major degrees of pelvic deformities.

    Vaginal delivery

    Indication for LS.C.S present

    Caesarean section

    Sri Lanka College of Obstetrics and Gynaecology Health sector development Project Guidelines- Management of breech presentation

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