Breech presentation

Question 1

Types of breech

Answer 1

1. Extended breech
2. Flexed breeches
3. Footling breeches

Question 2

Extended breeches

Answer 2

• Both legs extended with feet by head

- Presenting part is the buttocks

Question 3

Flexed breeches

Answer 3

• Legs flexed at the knees to both buttocks and feet are presenting

Question 4

Footling breeches

Answer 4

One leg flexed and one extended

Question 5

What is a breech presentation?

Answer 5

1. Occurs when the baby’s buttocks lie over the maternal pelvis
2. Lie is longitudanal and head is found in the fundus

Question 6

Causes of breech presentation

Answer 6

1. Idiopathic
2. Preterm delivery
3. Previous breech presentation
4. Uterine abnormalities - fibroids
5. Placenta previa
6. Fetal abnormalities

Question 7

Fetal consequences of breech presentation

Answer 7

1. Increased risk of hypoxia and trauma in labour

Question 8

Maternal consequences of breech presentation

Answer 8

Delivered by C section

Question 9

Diagnosis of breech presentation

Answer 9

1. Before 36 weeks it is not important unless in labour

2. Ultrasound can confirm the diagnosis

Question 10

External cephalic version

Answer 10

method for manually turning a breech or transverse presentation into a cephalic one

Question 11

When can ECV be performed?

Answer 11

1. 36 weeks in nulliparous women

2. 37 weeks in multiparous women

Question 12

Precautions taken in an ECV

Answer 12

1. CTG performed

2. Anti D given if mother is RH - ve

Question 13

ECV success rate

Answer 13

50%

Question 14

Absolute contraindications to ECV

Answer 14

1. C sections already indicated
2. Antepartum haemorrhage
3. Fetal compromise
4. Pre eclampsia
5. Oligohydraminios

Question 15

Main mode of delivery in Breech

Answer 15

C section

Question 16

Vaginal delivery of breech fetus

Answer 16

1. Extended breech presentation
2. Spontaneous onset of labour
3. etus not compromised